Prevalence of over-the-counter drug-related overdoses at Accident and Emergency departments in Northern Ireland - a retrospective evaluation
Open accessAbstract
BACKGROUND AND OBJECTIVES: One major concern associated with misuse/abuse of over-the-counter (OTC) products is the potential for over-dosage. The aim of this research study was to evaluate, over a 3-month period, OTC medicine-related overdoses (those involving OTC drugs only and OTC drugs in combination with other drugs) that led to patients presenting at the Accident and Emergency (A & E) departments in four Belfast hospitals. METHODS: A data collection sheet was designed to capture the information required from the A & E records in each hospital. A retrospective week-by-week data collection, reviewing A & E records, took place over a 3-month period (starting on 1 December 2002). All data related to cases presenting at the A & E departments because of drug overdoses (either accidental or deliberate according to Read Clinical Classification) were included in the study. Data were coded and entered into a custom designed SPSS database for analysis, using Chi square and Fisher exact tests. RESULTS: OTC drug-related overdoses comprised 40.1% of all overdoses, of which 24.0% were OTC-only overdoses. Those who overdosed on OTC drugs (solely or combined with other drugs) were mainly female (62.3%) and in the age category 31-50 years (44.9%; P <0.05). The majority (n=215) of OTC-related overdoses were intentional, whereas only 28 were accidental. Of those who attended the A & E departments and had an overdose history, one-third overdosed on OTC-related products and two-thirds overdosed on OTC drugs only. CONCLUSIONS: OTC drugs accounted for a significant proportion of overdose presentations at the A & E departments in Northern Ireland. Higher awareness of the potential of OTC product use in overdose cases (intentional or accidental) is recommended for both the public and health care professionals.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A study in Ireland found that paracetamol was used in over half of all overdoses using OTC drugs.
“A study in Ireland found that paracetamol was used in over half of all overdoses using OTC drugs [232].”
From Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease (2023) · cites this paper as [232]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Deliberate self harm in adolescents: self report survey in schools in England
Hawton, K., Rodham, K., Evans, E., & Weatherall, R. (2002) · BMJ · doi:10.1136/bmj.325.7374.1207 · Cited by 1,008 · cited 1× · see citing works
“The second most popular OTC drug ingested in intentional overdose was aspirin (7Æ2%); however, this was slightly less than that reported in Oxford in 1995 (12%) (18).”
ResultSensory Neuropathy from Pyridoxine Abuse
Schaumburg, H. H., Kaplan, J. G., Windebank, A. J., Vick, N. A., Rasmus, S. C., Pleasure, D., & Brown, M. J. (1983) · New England Journal of Medicine · doi:10.1056/nejm198308253090801 · Cited by 705 · see citing works
Lj, G. (2019) · BDJ · doi:10.1038/41415.1476-5373 · Cited by 387 · see citing works
Hawton, K., Townsend, E., Deeks, J., Appleby, L., Gunnell, D., Bennewith, O., & Cooper, J. (2001) · BMJ · doi:10.1136/bmj.322.7296.1203 · Cited by 383 · see citing works
BMA (2003) · Cited by 245 · see citing works
Toxicity of Over-the-Counter Cough and Cold Medications
Gunn, V. L., Taha, S. H., Liebelt, E. L., & Serwint, J. R. (2001) · PEDIATRICS · doi:10.1542/peds.108.3.e52 · Cited by 155 · see citing works
Why patients choose paracetamol for self poisoning and their knowledge of its dangers
Hawton, K. E., Ware, C., Mistry, H., Hewitt, J., Kingsbury, S., Roberts, D., & Weitzel, H. (1995) · BMJ · doi:10.1136/bmj.310.6973.164 · Cited by 113 · see citing works
Changing patterns of self-poisoning in a UK health district
Bialas, M. C., Reid, P., Beck, P., Lazarus, J. H., Smith, P., Scorer, R. C., & Routledge, P. A. (1996) · QJM · doi:10.1093/qjmed/89.12.893 · Cited by 99 · see citing works
Suicide and attempted suicide among older adults in Western Australia
Lawrence, D. M., Almeida, O. P., Hulse, G. K., Jablensky, A. V., & Holman, C. D. J. (2000) · Psychological Medicine · doi:10.1017/s0033291799002391 · Cited by 86 · see citing works
Routledge, P. A., Vale, A., Bateman, D. N., Johnston, G. D., Jones, A., Judd, A. M., Thomas, S. H. L., Volans, G. N., Prescott, L. F., & Proudfoot, A. T. (1998) · BMJ · doi:10.1136/bmj.317.7173.1609 · Cited by 71 · see citing works
Reduction in incidence of severe paracetamol poisoning
Prince, M. I., Thomas, S. H., James, O., & Hudson, M. (2000) · The Lancet · doi:10.1016/s0140-6736(00)02354-0 · Cited by 70 · see citing works
Sheen, C. L., Dillon, J. F., Bateman, D. N., Simpson, K. J., & MacDonald, T. M. (2002) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.701 · Cited by 57 · see citing works
Hulse, G. K., Robertson, S. I., & Tait, R. J. (2001) · Addiction · doi:10.1046/j.1360-0443.2001.967105915.x · Cited by 54 · see citing works
Akwagyriam, I., Goodyer, L. I., Harding, L., Khakoo, S. I., & Millington, H. (1996) · Emergency Medicine Journal · doi:10.1136/emj.13.3.166 · Cited by 45 · see citing works
Severity of overdose after restriction of paracetamol availability: retrospective study
Robinson, D. (2000) · BMJ · doi:10.1136/bmj.321.7266.926 · Cited by 41 · see citing works
A third of Europeans and almost half of Americans use internet for health information
Eaton, L. (2002) · BMJ · doi:10.1136/bmj.325.7371.989/b · Cited by 40 · see citing works
Unintentional overdose of analgesia secondary to acute dental pain
Dodd, M., & Graham, C. A. (2002) · BDJ · doi:10.1038/sj.bdj.4801525 · Cited by 35 · see citing works
Why do people use paracetamol for suicide?
Gazzard, B., Davis, M., Spooner, J. B., & Williams, R. (1976) · BMJ · doi:10.1136/bmj.1.6003.212 · Cited by 34 · see citing works
Importance of emergency identification schemes: Figure 1
Morton, L., Murad, S., Omar, R., & Taylor, K. (2002) · Emergency Medicine Journal · doi:10.1136/emj.19.6.584 · Cited by 18 · see citing works
Pericoronitis and accidental paracetamol overdose: a cautionary tale
Sivaloganathan, K., Johnson, P. A., Bray, G. P., & Williams, R. J. (1993) · BDJ · doi:10.1038/sj.bdj.4808080 · Cited by 17 · see citing works
The Changing Profile of Poisoning and its Management
MacNamara, A. F., Riyat, M. S., & Quinton, D. N. (1996) · Journal of the Royal Society of Medicine · doi:10.1177/014107689608901104 · Cited by 16 · see citing works
Severity of overdose after restriction of paracetamol availability
Sheen, C., & MacDonald, T. M. (2001) · BMJ · doi:10.1136/bmj.322.7285.553 · Cited by 13 · see citing works
Drug related deaths in the community: A preventive role for accident and emergency departments?
Ryan, J. M. (2000) · Emergency Medicine Journal · doi:10.1136/emj.17.4.272 · Cited by 13 · see citing works
Limitation of over the counter sales of paracetamol
Cranney, M., Cranney, J., & Hs, S. (1998) · BMJ · doi:10.1136/bmj.317.7173.1657 · Cited by 10 · see citing works
O'Donnell, J. J., Brown, F. D., & Beattie, T. F. (1998) · BMJ · doi:10.1136/bmj.316.7142.1460 · Cited by 4 · see citing works
Accidental child poisoning. Child resistant packaging should be used on all over the counter drugs.
O’Donnell, J. J., Brown, F. D., & Beattie, T. F. (1998) · PubMed · Cited by 3 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- Routledge P, Vale JA, Bateman DN et al. (1998) Paracetamol (acetaminophen) poisoning. British Medical Journal, 317, 1609-1610.
- Heubi JE, Bien JP (1997) Acetaminophen use in children: more is not better. Journal of Paediatrics, 130, 175-177.
- Thomas MR, Jowett NI (2001) Restriction has not reduced admissions with self poisoning. British Medical Journal, 322, 553.
Cited by
Sorted by citations
Chidiac, A. S., Buckley, N. A., Noghrehchi, F., & Cairns, R. (2023) · Expert Opinion on Drug Metabolism & Toxicology · doi:10.1080/17425255.2023.2223959 · Cited by 215 · see citing works
Emergency Department Management of the Salicylate-Poisoned Patient
O’Malley, G. F. (2007) · Emergency Medicine Clinics of North America · doi:10.1016/j.emc.2007.02.012 · Cited by 165 · see citing works
Schifano, F., Chiappini, S., Miuli, A., Mosca, A., Santovito, M. C., Corkery, J., Guirguis, A., Pettorruso, M., Giannantonio, M. D., & Martinotti, G. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.657397 · Cited by 123 · see citing works
Predictive factors of self‐medicated drug use among the Spanish adult population
Carrasco‐Garrido, P., Jiménez‐García, R., Hernández‐Barrera, V., & de Miguel, Á. G. (2007) · Pharmacoepidemiology and Drug Safety · doi:10.1002/pds.1455 · Cited by 119 · see citing works
Brennan, R., Wazaify, M., Shawabkeh, H., Boardley, I. D., McVeigh, J., & Hout, M. C. V. (2021) · Drug Safety · doi:10.1007/s40264-021-01085-9 · Cited by 79 · see citing works
Self-citationCalamusa, A., Marzio, A. D., Cristofani, R., Arrighetti, P., Santaniello, V., Alfani, S., & Carducci, A. (2011) · Patient Education and Counseling · doi:10.1016/j.pec.2011.10.003 · Cited by 73 · see citing works
Use of over-the-counter (OTC) drugs and perceptions of OTC drug safety among German adults
Barrenberg, E., & Garbe, E. (2015) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-015-1929-5 · Cited by 60 · see citing works
González-Ponce, H. A., Rincón‐Sánchez, A. R., Jaramillo‐Juárez, F., & Moshage, H. J. (2018) · Nutrients · doi:10.3390/nu10020117 · Cited by 54 · see citing works
Abraham, O., Schleiden, L. J., & Albert, S. M. (2017) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-017-0467-x · Cited by 53 · see citing works
Wazaify, M., Hughes, C. M., & McElnay, J. C. (2006) · Patient Education and Counseling · doi:10.1016/j.pec.2005.12.008 · Cited by 48 · see citing works
Self-citationOTC analgesics and drug interactions: clinical implications
Fendrick, A. M., Pan, D. E., & Johnson, G. E. (2008) · Osteopathic Medicine and Primary Care · doi:10.1186/1750-4732-2-2 · Cited by 47 · see citing works
Conca, A., & Worthen, D. R. (2012) · Journal of Pharmacy Practice · doi:10.1177/0897190011431148 · Cited by 33 · see citing works
Characteristics of hospital-treated intentional drug overdose in Ireland and Northern Ireland
Griffin, E., Corcoran, P. E., Cassidy, L., O’Carroll, A., Perry, I. J., & Bonner, B. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-005557 · Cited by 32 · see citing works
Westerlund, T., Barzi, S., & Bernsten, C. B. (2017) · Pharmacy Practice · doi:10.18549/pharmpract.2017.01.894 · Cited by 30 · see citing works
Patients’ Opinions on Antibiotics in the Treatment of Dental Infections: A Cross-Sectional Survey
Domínguez-Domínguez, L., Castelo‐Baz, P., Cabrera-Fernández, A., Cabanillas‐Balsera, D., Segura-Egea, J. J., Segura-Egea, J. J., & Martín-González, J. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13072099 · Cited by 8 · see citing works
Profile of acute poisoning in three health districts of Botswana
Kasule, M., & Malangu, N. (2009) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v1i1.10 · Cited by 8 · see citing works
Kariya, A., Okada, H., Suzuki, S., Dote, S., Nishikawa, Y., Araki, K., Takahashi, Y., & Nakayama, T. (2023) · JMIR Formative Research · doi:10.2196/45021 · Cited by 7 · see citing works
Zhou, Y., Li, T., Zhou, S., Xu, H., Yin, X., Chen, H., Ni, X., Bai, M., Ao, W., Yang, J., et al. (2022) · Metabolic Brain Disease · doi:10.1007/s11011-022-01042-0 · Cited by 5 · see citing works
Ledford, C. J. W., Childress, M. A., Ledford, C. C., & Mundy, H. D. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.10.002 · Cited by 5 · see citing works
An investigation of non-prescription medicine supply in community pharmacies in Hanoi, Vietnam
Thang, X. (2013) · Nottingham ePrints (University of Nottingham) · Cited by 5 · see citing works
A Pharmacoepidemiological Study of Medicine Use among Finnish Conscripts
Linden, K. (2005) · Työväentutkimus Vuosikirja · Cited by 5 · see citing works
Hakariya, H., Yokoyama, N., Lee, J. K., Hakariya, A., & Ikejiri, T. (2024) · JMIR Formative Research · doi:10.2196/54023 · Cited by 4 · see citing works
Kalbani, R. J., & Wazaify, M. (2016) · Journal of Substance Use · doi:10.3109/14659891.2016.1144803 · Cited by 4 · see citing works
Self-citationAbe, T., Tokuda, Y., Stein, G. H., Ishimatsu, S., & Birrer, R. B. (2008) · The Open Critical Care Medicine Journal · doi:10.2174/1874828700801010012 · Cited by 4 · see citing works
Mittal, P., Gan, X. Y., Sim, A. Y., Yeo, J. Q., Cheng, J.-X., Shanmugham, S., & Hasan, S. S. (2018) · Journal of Pharmacy Practice and Research · doi:10.1002/jppr.1351 · Cited by 3 · see citing works
Al-Jaser, N., Cli., M., & Awofeso, N. (2013) · InTech eBooks · doi:10.5772/52879 · Cited by 3 · see citing works
Pharmaceutical care – a chance or necessity in the context of Polish self-medication
Majchrowska, A. (2018) · Polish Journal of Public Health · doi:10.2478/pjph-2018-0017 · Cited by 2 · see citing works
Paoli, G. D., Cassie, H., Ali, N., Crichton, M., & Radley, A. (2026) · Research Square · doi:10.21203/rs.3.rs-10242784/v1
- Authors
- Wazaify, M., Kennedy, S., Hughes, C. M., & McElnay, J. C.
- Affiliations
- University of Jordan (JO)
- Queen's University Belfast (GB)
- Venue
- Journal of Clinical Pharmacy and Therapeutics
- Publisher
- Hindawi Limited
- Published
- 2005-02
- Volume
- 30
- Issue
- 1
- Pages
- 39-44
- ISSN
- 0269-4727 (ISSN-L)
- 1365-2710
- OpenAlex
- W2158753893
- Cited by
- 29
- References
- 26
- Citations by year
- 2024: 2 · 2023: 3 · 2022: 1 · 2021: 2 · 2018: 3 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 2.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Pharmacy and Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- HRB National Drugs Library (Health Research Board) (submittedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion)
- Topics
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- over-the-counter drugs, drug overdose, accidental overdose, intentional overdose, emergency department presentation, Northern Ireland
- MeSH terms
- Acetaminophen, Age Factors, Alcohol Drinking, Aspirin, Data Collection, Drug Combinations, Drug Incompatibility, Drug Interactions, Nonprescription Drugs, Emergencies, Emergency Medical Services, Female, Humans, Ibuprofen, Male, Northern Ireland, Drug Prescriptions, Retrospective Studies, Self Administration, Social Class, Time Factors, Databases as Topic, Drug Overdose
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
