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Q J Med 2003; 96: 125-132
© 2003 Association of Physicians

Changes in paracetamol, antidepressants and opioid poisoning in Scotland during the 1990s

D.N. Bateman, M. Bain1, D. Gorman2 and D. Murphy1

From the Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh 1 Information & Statistics Division of the Common Services Agency, Edinburgh, and 2 Public Health, Lothian Health, Edinburgh, UK

Received 12 February 2002 and in revised form 22 November 2002

Background: Overdose is one of the commonest causes of medical admissions to UK hospitals. In Scotland (pop. 5.1 million), all NHS hospital discharge data is uniquely linked to enable identification of individuals re-presenting with the same diagnosis.

Aim: To examine trends in discharges for poisoning, in particular paracetamol, antidepressants and opioids from 1990–99.

Design: Retrospective analysis.

Methods: Discharge data from the Scottish Morbidity Record (SMR01) and mortality data from the General Register Office for Scotland (GROS) were analysed for 1990–99 by age and gender for the relevant codes.

Results: Overall discharge rates increased until 1997, after which they fell. This pattern was seen in paracetamol-related discharges, but not for antidepressants or for opioids. Overdose was more common in females, except for opioids. Discharges related to opioids increased in an exponential manner over the decade, five-fold in women and six-fold in men in 10 years.

Discussion: Increases in opioid-related presentations are of major concern. Changes in paracetamol pack-size have been associated with reduced discharge rates. In Scotland the age group with the highest rate of discharge (15–24 years) with paracetamol overdose is not the one with the highest mortality.

Address correspondence to Dr D.N. Bateman, Scottish Poisons Information Bureau, 1 Lauriston Place, Edinburgh EH3 9YW. e-mail: spib{at}luht.scot.nhs.uk


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