Prescribers aware: a cross-sectional study from New Zealand emergency departments on the substances used in intentional self-poisoning and their sources

Abstract

INTRODUCTIONIntentional self-poisoning or self-harm through poisoning, is a common cause of presentations to emergency departments (EDs). National datasets do not allow identification of the substances most commonly used in hospital-treated intentional self-poisoning in New Zealand, nor do they capture sources of these substances. AIMTo investigate the specific substances used in intentional self-poisoning and the sources from which they are obtained. METHODSIn this cross-sectional study, information about the demographics and presentation particulars of intentional self-poisoning patients aged ≥16 years, presenting to three public EDs, as well as the substances they used in the self-poisoning event and the sources of these agents, were collected prospectively. RESULTSA total of 102 patients were recruited from the potentially eligible 1137 intentional self-poisoning patients presenting to the three EDs during the study period. Seventy per cent used their own prescription medications and 24% used medicines they purchased themselves. Paracetamol and ethanol were most commonly encountered substances. Patients presented a median of 1.9h after exposure (interquartile range 1.0–3.3h), 62% self-referred, 60% presented to the ED in the evening or at night and 66% were triaged into Australasian Triage Scale 3 (to be seen within 30min). Two-thirds were referred to emergency psychiatric services. DISCUSSIONCollecting specific substance information, such as from this study, can assist in planning specific activities to prevent intentional self-poisoning. As most people used their prescribed medicines, the findings can inform and assist doctors in their prescribing practices when they manage patients at risk of self-poisoning.

Presence of alcohol and other drug use within youth mental health presentations to the emergency department: A single‐site retrospective observational study

“…A recent New Zealand study of intentional self-poisoning from ED presentations in those aged 16 and over found that 70% had ingested their own prescription medication. 27 While we were unable to systematically determine the source of substances ingested, our paediatric sample was skewed more towards ingestion of over-the-counter medications. This suggests that harm reduction interventions such as reduced pack sizes, or an age restriction on purchasing, may be effective in this age group.…”

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