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Australian women and young girls over-represented in paracetamol overdoses, as sale restrictions loom

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In short:

From February next year, packet sizes of paracetamol will shrink in supermarkets and convenience stores, and pharmacies will have limits on how much can be sold without pharmacist approval.

Statistics collected from each state and territory by the ABC show while overall paracetamol overdoses are down, young girls are over-represented in the figures.

While paracetamol is safe if people take the recommended doses, it can cause serious harm to the liver, or worse, if abused in high doses.

WARNING: This story contains references to acts of self-harm.

Paracetamol is one of the most common medications in Australia, but soon it is going to be harder to buy in large quantities as authorities try to prevent people from overdosing.

Figures obtained by the ABC show an overwhelming over-representation of women and young girls overdosing on the pain medication, with thousands turning up to emergency departments around Australia every year for help.

Perth mother Rebecca — who did not want to be identified by her real name — said her daughter first overdosed on paracetamol when she was just 14.

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"I didn't actually have paracetamol in our house once my kids were teenagers … [but] my daughter still bought it, still stole it and still overdosed on it," Rebecca said.

"She purchased the paracetamol from a small supermarket on her way home from school one day and she took it two weeks later."

The teen went on to self-harm with the medication multiple times.

"We are really lucky that she is still alive," Rebecca said.

Data shows teen trend

The ABC contacted each state and territory health department to gather data on paracetamol overdoses.

In WA alone, 1,485 people presented to emergency departments with paracetamol poisoning in the two years to July this year.

More than 500, or 34 per cent, were girls aged 16 and under.

Paracetamol doesn't cure the causes of pain but it does provide temporary relief. (ABC Science: Tegan Taylor)

In Victoria and the Northern Territory, it's about 30 per cent. In the ACT, 26 per cent, while in Tasmania more than a third of ED presentations for paracetamol overdoses are girls under 17.

The South Australian and Queensland health departments say their hospitals don't record paracetamol overdoses, while NSW Health wouldn't give the ABC any information relating to self-harm by paracetamol.

The Therapeutic Goods Administration (TGA) says the number of people using paracetamol to deliberately hurt themselves is increasing.

However, the figures collected by the ABC show overall there was a slight drop in overdoses last financial year compared with the previous year.

Spike in teen self-harm

Toxicologist Nicholas Buckley, the co-author of a report that led to the paracetamol sale restrictions, said teenage girls had long had the highest rates of self-harm.

"But those rates, particularly in the 12 to 14 year age group, have literally gone up six times in the last 12 years," he said.

Paracetamol quick hits:

  • Paracetamol has been used in Australia for the relief of mild and moderate pain and fever for people of all ages since the 1950's.
  • The recommended usage for adults is no more than 1 gram of paracetamol every 4 to 6 hours, with a maximum of 4 grams a day.
  • That dosage is less for children, depending on their body weight.
  • An overdose can damage the liver and cause death.
  • Symptoms of an overdose include abdominal pain, nausea, vomiting; and at the severe end of the spectrum — liver problems, seizure, coma and death.

Source: TGA

Most teens who overdosed did not regularly take prescription medication, so "they just grab whatever meds are in the house, and that is most commonly paracetamol".

Professor Buckley stressed paracetamol was not the problem in itself, but its easy availability was the issue.

"In therapeutic doses, paracetamol is literally one of the safest medications we have if people are taking recommended doses, it has very few side effects and causes no problems," he said.

"Most of these overdoses are impulsive overdoses in teenagers less than half an hour of thinking about it, just grabbing whatever's in the house.

"And so if there's less medication stockpiled in the house, then then you have smaller overdoses and less likelihood [of serious health outcomes]."

But Professor Buckley conceded the number of overdoses was driven by poor mental health, and reducing the availability of paracetamol was unlikely to reduce overdoses.

"But if there are less large overdoses, there will be less serious liver injury and less deaths," he said.

Australian women and young girls over-represented in paracetamol overdoses, as sale restrictions loom

Paracetamol overdoses can lead to liver damage and death. (ABC News: Mark Evans)

Pack sizes cut

From February, paracetamol pack sizes available at supermarkets and convenience stores will be reduced from 20 to 16 tablets.

In chemists without the supervision of a pharmacist, people would only be allowed to buy packs of 50 tablets.

And pack sizes of up to 100 tablets can only be sold with a pharmacist's authorisation.

Smaller packs have already started appearing on shelves ahead of the changes.

Rebecca believed the medication should only be available behind-the-counter at all times.

Australian women and young girls over-represented in paracetamol overdoses, as sale restrictions loom

Rebecca wants paracetamol to be kept behind the counter in pharmacies. (ABC News: Nicholas Martyr)

"For some that would be enough of a barrier to not be able to purchase, and they wouldn't be able to steal so easily if they are behind the counter either," Rebecca said.

The TGA is running an awareness campaign about how to use and store paracetamol to minimise harm.

The Australian Medical Association's vice president Julian Rait said ideally paracetamol would be sold from behind the counter, but the organisation was supportive of the reduction in pack sizes.

Associate Professor Rait said the TGA had to balance the needs of people suffering from chronic pain, who needed to access paracetamol in larger quantities, against the risk of people who may use the drug impulsively.

Australian women and young girls over-represented in paracetamol overdoses, as sale restrictions loom

Julian Rait says the AMA would support tighter controls on the sale of a paracetamol. (Supplied: Australian Medical Association)

"We've advocated for up-scheduling, so that as far as is possible these would be behind the counter," he said.

"But we do recognise that for everyday use, small quantities should still be available.

"And so the proposal was to have no more than 16 tablets in a blister pack, and we think that this can reduce the impulsive consumption of these tablets and minimise the potential for self harm."

Associate Professor Rait warned people were at risk of permanent liver damage, or complete liver failure, if they misused paracetamol.

Federal Health Minister Mark Butler described the incidents of overdosing on paracetamol as a "serious public health concern" when he was asked about the issue on Saturday.

Mr Butler said the deaths associated were a tragedy and those who survived were often left with long-term kidney damage.

"There has been quite a detailed consultation led by the medicines authority through 2022 and 2023 to consider the access to paracetamol," he said.

A requirement for a prescription was considered but different interests needed to be managed, he said.

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