Primary prevention

Public health interventions, such as legislation regarding acetaminophen availability and packaging, may lead to reductions in deaths from self-harm. There is some evidence that legislation introduced in 1998 in the UK limiting the number of acetaminophen tablets purchased at a single time may have had a small effect in reducing the number of suicides related to acetaminophen ingestion.[47][48] More recently, a combination tablet of acetaminophen and dextropropoxyphene (known as co-proxamol in the UK) has been withdrawn in the UK owing to its implication in a large number of poisoning deaths. In addition to a major reduction in deaths associated with co-proxamol, research suggested that there was little evidence of substitution of suicide method related to increased prescribing of alternative analgesics.[49]

In 2014, US manufacturers stopped marketing prescription combination drug products with more than 325 mg of acetaminophen per tablet, capsule, or other dosage unit to protect consumers from the risk of severe liver damage.[50]

Secondary prevention

Patients with a history of intentional self-harm should be referred for psychiatric evaluation and disposition only when they are medically stable. For accidental acetaminophen poisoning, the patient (and/or the guardian of a minor patient when applicable) should undergo education regarding the safe use of drug treatments.

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