Two-thirds of teens used paracetamol in overdoses – CUH study

Two-thirds of teenagers taken to Cork University Hospital (CUH) after they overdosed on drugs had used paracetamol, while more than half had used a cocktail of drugs, a new study has found.

The study in the Irish Medical Journal analysed data on all 85 adolescents seen at the paediatric emergency unit of CUH for drug overdose from January 2014 to December 2016.

Many suffered from depression, while three-quarters of them were found to have had mothers and maternal grandmothers who were also treated for depression.

All bar two of the adolescents had used painkillers to overdose – 67.5 per cent had used paracetamol, while other drugs used included antidepressants, antipsychotics, antibiotics, and antihistamines.

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Over half (54.1 per cent) of the teenagers had used more than one drug in their overdose attempt. Three (3.5 per cent) had inhaled kitchen spray aerosols. Nearly a fifth had mixed alcohol and drugs.

Self-harm

Thirty-eight had self-harmed previously, including cutting skin, hanging and near drowning, while 14.1 per cent had been seen by doctors after they had overdosed before.

“Self-harm, even that performed outside of a suicide attempt, is well known to be a major risk factor for future suicide attempts; as such, intense efforts should be made to reduce or prevent incidents of self-harm, irrespective of the type,” the study’s authors said.

Three of the youths had lost a parent to suicide, and all three of them had self-harmed. Others reported family troubles, cyber-bullying, moving house, doubts over sexual orientation, or school stress.

One in seven of them had broken up with a boyfriend or a girlfriend before they overdosed, while 10 of them had left behind a suicide note before they were found.

Most of the study patients were aged between 14-16 years while the youngest patient was just 11 years old. The majority (81.2 per cent) were female, similar to other such studies.

“The numbers in this study probably represent only the tip of the iceberg, as it is likely that substantial numbers of recorded self-poisoning occur in the community,” the study authors said.

Health services

A third (28) of the 85 patients had been under the care of the HSE Child and Adolescent Mental Health Services (CAMHS), with a diagnosis prior to their admission for overdose.

Seventy-one (83.5 per cent) were reviewed by CAMHS staff. Thirteen per cent were assessed by a medical social worker before discharge. Six were transferred to a CAMHS in-patient unit.

The fact that not everyone is assessed by medical staff is explained “by limited manpower and unavailability” of staff as the majority of those seen are treated during on-call hours”, said the report.

No deaths were recorded during the study, but 12 of them had to be treated again after another overdose within two years. The vast majority (83 per cent) of these were female.

Suicide is the third most common cause of death among adolescents globally. Poisoning is the leading cause. Understanding the triggers could help to find ways of preventing suicides, said the authors.

The CUH study is the first in Ireland that has specifically evaluated the presentations and preceding factors of overdose in adolescents seen in paediatric settings, the authors believe.