Exclusive:Pharmacists call for action after thousands of paracetamol poisoning hospital admissions in Scotland

Figures have revealed 24,014 inpatient and day-case admissions to hospitals in Scotland have taken place over the space of five years as a result of intentional paracetamol poisoning, including overdose cases. The statistics show around 5,000 admissions a year from 2018 to 2023, with the numbers peaking in 2019-20 at 5,132 admissions.

Separate figures from the National Records of Scotland show that from 2018 to 2022, 205 drug-poisoning deaths involved paracetamol.

The alarm comes amid warnings over teenagers reportedly taking part in a TikTok “paracetamol hospital challenge” in which young people attempt to get themselves admitted to hospital by taking too much of the painkiller.

The Royal Pharmaceutical Society (RPS) is calling on the UK government to pass legislation to prohibit, in law, retailers from offering multi-buy deals on paracetamol, which are only restricted by voluntary guidelines.

There are no legal restrictions on the number of paracetamol packs that can be purchased in a single transaction provided the total amount does not exceed 100 tablets.

The RPS has previously clashed with Poundland as the retailer sells three packs of paracetamol for £1, which contravenes guidance issued by the Medicines and Healthcare products Regulatory Agency (MHRA) for a maximum of two packs of 16.

Pharmacists are warning the thousands of Scottish hospital admissions for paracetamol poisoning should act as a wake-up call to politicians to tighten the law around the sale of the drug.

Laura Wilson, director for Scotland at the RPS, told The Scotsman the figures were “obviously hugely concerning”.

She said: “Misuse of paracetamol can pose significant risks to health and in some cases, can cause death. When used correctly, paracetamol is a very safe and effective medicine. However, the Royal Pharmaceutical Society is concerned about some selling practices associated with paracetamol and has already called on the UK government to pass legislation prohibiting retailers from offering multi-buy deals on this medicine.

“Multi-buy deals are in direct violation of voluntary sales guidelines set out by the Medicines and Healthcare products Regulatory Agency that exist to help prevent overdose and allow large quantities to be obtained in one purchase.”

NHS Inform warns that taking too much paracetamol “can be very dangerous”, stating that if a person has taken more than the recommended maximum dose, they should “go to [their] nearest accident and emergency (A&E) department as soon as possible”.

The advice adds some people feel sick, vomit or experience abdominal pain after taking too much of the painkiller, but it warns “often there are no obvious symptoms at first”, with the advice to “go to A&E even if you’re feeling well”.

Last year, police launched an investigation after teenagers in Southampton overdosed on paracetamol in a reported TikTok challenge to see who could stay in hospital the longest.

Police said teenagers “decided to challenge each other to take a paracetamol overdose to see who could get hospitalised and who could get hospitalised the longest”, adding “the person remaining in hospital for the most hours being the person who won the challenge”.

Ms Wilson said: “This alarming TikTok trend demonstrates the need to raise awareness amongst children and young people of the potential harmful nature of all medicines, including those they are familiar with and that are easily accessible such as paracetamol, and of the need to use all medicines responsibly.

“Sadly, not all young people will be aware of the huge risks and potentially severe consequences of their actions, and therefore we all have a responsibility to get this message across. This further underlines the need for stricter regulation when it comes to the selling of paracetamol.”

Katy Clark, Scottish Labour MSP for West Scotland, said: “I am deeply disturbed to read about this latest trend and how it has impacted on some young people. I am also concerned by the revelation that no specific data is held on intentional paracetamol overdose here in Scotland.

“Constituents of mine who work in the health service tell me that over recent years, they have seen a notable uptake in intention paracetamol overdose among young people. This must be scrutinised further by the Scottish Government, given the commitment to ensuring suicide prevention and self-harm strategies are evidence-informed.”

Ms Clark added: “Paracetamol is, of course, a generally safe and reliable painkiller to treat aches, pains and fevers. But experts are also clear that it is one of the more dangerous non-prescription medications to overdose on.

“Given its wide accessibility, the Scottish Government must listen to health professionals, evaluate evidence and consider whether further barriers need to be placed to deter misuse, whether that be placing products behind counters or reviewing quantities.”

The MHRA said most retailers adhere to the guidelines on not promoting multiple purchases and have introduced in store measures such as till bars that restrict sales to a maximum of two packs across a range of products containing aspirin, paracetamol or ibuprofen.

Alison Cave, chief safety officer of the MHRA, said: “The MHRA has worked closely with stakeholders representing both large and small retailers, pharmacists, trading standards offices and the pharmaceutical industry to develop best practice guidance on the sale of medicines for pain relief.

“The guidelines recommend a maximum of two packs of any medicines for pain relief, including aspirin, paracetamol or ibuprofen.

"The MHRA has published guidance on the sales of analgesics such as paracetamol, discouraging multi-buy promotions that encourage consumers to buy more than they need.

“Where we identify cases where the guidance is not being followed, we contact the retailer concerned to highlight the reasons for the guidelines and to take reasonable actions to mitigate the risks of accidental or impulsive overdose.”

A Scottish Government spokesperson said: “Intentionally overdosing on paracetamol is a serious issue.

"People can seek help from a range of sources, including The Samaritans, Breathing Space and from Self-Harm Network Scotland, which provides compassionate support as well as information and advice for anyone concerned about self-harm, by this or any other method.

“The Medicines and Healthcare products Regulatory Agency (MHRA), in combination with non-pharmacy retailers, already limit the sale of paracetamol to a maximum of two packs containing up to 16 solid dose tablets or capsules. The aim of these voluntary measures is to balance the need of people for access to pain relief medicines against the dangers for vulnerable individuals and reduce the opportunity for people to purchase, on impulse, excessive quantities of paracetamol.

“The Scottish Government and Cosla’s suicide prevention strategy, Creating Hope Together, is prioritising high-risk groups like children and young people and ensuring that all government policies take action to reduce suicide as part of our whole of government and society approach.”

Samaritans has a 24-hour helpline offering emotional support for anyone feeling down, distressed or struggling to cope. They can be called on 116 123 or emailed at [email protected].