Curb on paracetamol will save lives

Controls are to be imposed on the sale of paracetamol and aspirin, two of the most widely used painkillers, to reduce the number of deaths caused by overdoses, ministers announced yesterday.

The measures are expected to prevent 3,000 overdoses and a dozen deaths a year, health officials said. Packs of the drugs sold in supermarkets and general stores are to be restricted to a maximum of 16 tablets or capsules. Larger packs containing up to 32 tablets will be available from pharmacies but shoppers are expected to be restricted to one apiece.

The aim of the restrictions is to reduce the number of pills left lying in medicine cabinets which are available to be seized and swallowed on impulse by those, especially teenagers, in despair. Between 30,000 and 40,000 people are admitted to hospital each year with paracetamol overdoses and 100 to 150 die. A key reason for the high number of admissions and deaths is thought to be the easy availability of the pills and ignorance about their dangers in overdose, although ministers accept that a determined suicide cannot be stopped. Paracetamol is one of the safest drugs at the recommended dose - two tablets every four to six hours, with a maximum of eight in any 24 hours - but an overdose of 20 to 30 may cause liver failure unless medical help is obtained rapidly. Victims have been known to swallow 60 to 70 tablets without throwing up but this is more likely if the pills are combined with alcohol. There are no early warning signs of an overdose until the victim collapses in a coma.

Alan Milburn, health minister, said: "Analgesics are safe and effective when used at the recommended doses. But overdoses can have serious consequences. The toll of deaths from paracetamol overdoses calls for action to improve public safety."

Ministers also announced yesterday that terfenadine, a popular drug for hayfever, is to be formally removed from over- the-counter sale and made available only on prescription from 16 September because of evidence that it can cause heart problems. Since 1982, 37 people have suffered heart rhythm disorders associated with the drug and 15 have died.

Officials emphasised that it was safe when used correctly, but could be dangerous when taken with certain other drugs or grapefruit juice, which affected the way it was broken down by the body. Eleven popular anti-hay fever products contain the drug.

The controls on paracetamol and aspirin follow nine months' consultation and are to be introduced from September next year to give manufacturers time to prepare the new packaging, which will also carry clearer warnings about the risk of overdose.

Pharmacists will have discretion to supply up to 100 pills to customers suffering from chronic conditions such as arthritis but larger quantities will be available only on prescription. The same restrictions are being imposed on aspirin, which accounts for 5,000 hospital admissions a year and 60 deaths.

Life and death: the cold facts

Overdoses account for one in ten of all admissions to hospital.

Among 15- to 19-year-olds, one in 100 is admitted to hospital with an overdose every year.

Not all those who attempt suicide mean to kill themselves. About 25 people attempt suicide for every one who succeeds; among the young the figure rises to 100 to one.

More than eight out of ten suicide attempts are by women. Taking an overdose is their favoured method.

But men succeed more often. They are four times as likely to take their own lives, and favour hanging and shooting.

Choice of method is influenced by availability. Shooting is most common among farmers and landowners with access to guns. Doctorstend to choose poison.