Millions of Australians could be affected by a proposal to limit paracetamol sales.
It’s often our first port of call for pain relief, readily available at many retail outlets and most people wouldn’t think twice about not locking it up at home. But a government report recommends curtailing retail sales of paracetamol and transferring some products to prescription-only.
The push is prompted by a report commissioned by the Therapeutic Goods Administration (TGA) in response to the incidence of suicide or suicide attempts using paracetamol.
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The report proposes reducing pack sizes, reducing buying limits to one or two packs, making modified release paracetamol available only through prescription, and restricting sales to those aged 18 or over.
Paracetamol is mostly sold in Australia under the Panadol or Panamax labels.
The Sydney Morning Herald (SMH) says the health industry, including doctors and GPs, broadly support the potential changes. But people who suffer from chronic pain are apprehensive.
Pain Australia (PA) chief executive Giulia Jones told the SMH the changes would unfairly affect chronic pain sufferers.
“There are 3.4 million Australians who live with chronic pain, and many of them use paracetamol every day without a script because going to the GP costs money,” she says.
In its submission to the TGA study, PA said it did not support further restrictions on paracetamol sales. Modified release paracetamol products were made pharmacy-only in 2020.
“This policy places the same requirements on accessing paracetamol as alcohol or tobacco which are clearly more harmful in general to society,” says the PA submission.
Modified release (MR) paracetamol is used to treat chronic pain, especially in the elderly. Immediate release (IR) paracetamol is available at supermarkets and other retail outlets.
Codeine products such as Nurofen Plus and Panadeine were made prescription-only in 2018 due to concerns about addiction.
The suggestion to impose buying limits and reduce pack sizes was prompted by poisoning attempts.
The report found that while impulsive and planned overdoses occur at similar rates, impulsive overdoses often use paracetamol already in the home.
It was also claimed that while larger packs were popular with consumers, they were more frequently used in overdose cases.
The TGA’s other recommendations included improving public education about the potential harm of paracetamol, maintaining and expanding follow-up care after self-harm and increasing awareness about storing medicines safely and reducing any stockpiles.
The TGA report states that survival rates from a paracetamol overdose are excellent, but only where medical treatment is sought within two to six hours of the incident. If treatment is delayed, there is a risk of serious liver injury, and sometimes death.
Treatment of overdose is also more challenging following ingestion of MR paracetamol than IR paracetamol.
According to TGA data, paracetamol poisonings lead to about 50 deaths a year in Australia, and about five times that number in self-poisonings.
Paracetamol poisoning is the most common cause of acute liver failure in most of the Organisation for Economic Co-operations and Development (OECD) countries.
The TGA will meet next week to consider its decision.
Do you use paracetamol? Which brands? How would restrictions affect you? Why not share your thoughts in the comments section below?