Stocks of paracetamol products stored in urban New Zealand households: A cross-sectional study

Background Intentional self-harm is a common cause of hospital
presentations in New Zealand and across the world, and self-poisoning is
the most common method of self-harm. Paracetamol (acetaminophen) is
frequently used in impulsive intentional overdoses, where ease of access
may determine the choice of substance. Objective This cross-sectional
study aimed to determine how much paracetamol is present and therefore
accessible in urban New Zealand households, and sources from where it has
been obtained. This information is not currently available through any
other means, but could inform New Zealand drug policy on access to
paracetamol. Methods Random cluster-sampling of households was performed
in major urban areas of two cities in New Zealand, and the
paracetamol-containing products, quantities, and sources were recorded.
Population estimates of proportions of various types of paracetamol
products were calculated. Results A total of 174 of the 201 study
households (86.6%) had at least one paracetamol product. Study households
had mostly prescription products (78.2% of total mass), and a median of
24.0 g paracetamol present per household (inter-quartile range 6.0-54.0
g). Prescribed paracetamol was the main source of large stock. Based on
the study findings, 53% of New Zealand households had 30 g or more
paracetamol present, and 36% had 30 g or more of prescribed paracetamol,
specifically. Conclusions This study highlights the importance of
assessing whether and how much paracetamol is truly needed when
prescribing and dispensing it. Convenience of appropriate access to
therapeutic paracetamol needs to be balanced with preventing unnecessary
accumulation of paracetamol stocks in households and inappropriate access
to it. Prescribers and pharmacists need to be aware of the risks of such
accumulation and assess the therapeutic needs of their patients. Public
initiatives should be rolled out at regular intervals to encourage people
to return unused or expired medicines to pharmacies for safe disposal.