Patient Characteristics Associated with Nonprescription Drug Use in Intentional Overdose

Abstract

Suicide-prone patients with a diagnosis of substance abuse and who possess prescription medications are unlikely to use OTC medications in overdose. For this cohort, this represents a relatively small proportion of patients whom clinicians should consider to be at greater risk for attempting suicide when using OTC medication, especially acetaminophen.

Patient perceptions of the potential lethality associated with deliberate self‐poisoning

“…As expected, patients who reported that they intended to kill themselves considered their overdose potentially more lethal than patients who denied suicidal intent, but this does not correlate with the real potential lethality as assessed by Clinical Toxicologists. Whereas it is commonly believed that men make more serious attempts than women and older people more than younger people, [6][7][8] we found no evidence to support this. Similarly, contrary to previous studies that suggested that prescription medications are considered more dangerous in overdose by the lay public, 10 our results indicate that patients tend to perceive as being equally lethal both prescription medications and substances that they buy over the counter.…”

“…The median Pierce SIS was 8.5/25 (IQR [4][5][6][7][8][9][10][11][12] and the correlation between the patient VAS and Pierce SIS was strong (r = 0.73, P < 0.0001). The correlation between the toxicology VAS and Pierce SIS was r = 0.25 (P = 0.0004).…”

“…It is commonly believed that men make more serious attempts than women and older people more than younger people. [6][7][8] Previous studies show that patients underestimate the harm of drugs taken in overdose and lack knowledge regarding the side-effects for both over-the-counter and prescription medications. 9,10 The general population believes that prescription medications are more lethal in overdose.…”

“…4,12 Yet with increasing age there is a decrease in suicide attempts but an increase in completed suicide. [6][7][8] Little is known about how patients perceive the lethality of their overdose. The aim of the present study was to assess patients' perceptions of the potential lethality of the drugs that they have taken in DSP.…”

Characteristics of medication overdose presentations to the ED: how do they differ from illicit drug overdose and self-harm cases?

“…At least 90% have a diagnosable psychiatric condition,3 8 most frequently depression,1 3 10 14–17 although substance use disorders, personality disorders, anxiety-related disorders, eating disorders and schizophrenia are also common 3 9 18 19. Alcohol has been estimated to be involved in 28–40% of cases 10 13 20. Despite being highly recommended, psychosocial assessment of self-poisoning patients occurs in only around half of cases 9 21…”