The challenge
Paracetamol overdoses were killing people in England and Wales and causing liver damage serious enough to need a transplant.
The case
In September 1998, following recommendations from the UK Medicines Control Agency, the UK government restricted packs of paracetamol sold over the counter to a maximum of 32 tablets in pharmacies and 16 tablets elsewhere. Researchers led by Keith Hawton at the University of Oxford compared deaths over the following 11¼ years with what pre-legislation trends predicted. Deaths in England and Wales from paracetamol alone with suicide or undetermined verdicts fell by an estimated 43%, about 765 fewer deaths. The fall held when accidental poisonings were included and after accounting for trends in other suicide methods. Registrations for liver transplants fell 61%, but there was no reduction in actual transplants.
Why it worked
Making a common medicine harder to buy in large amounts was followed by hundreds fewer deaths. The researchers noted that deaths continued, so further prevention measures are still needed.
Sources
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