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Painkillers are sold in packs of max 16 tablets in the UK (almost always 500mg for paracetamol, 200mg for ibuprofen). In addition they must be sold in blister p

Painkillers are sold in packs of max 16 tablets in the UK (almost always 500mg for paracetamol, 200mg for ibuprofen). In addition they must be sold in blister packs not bottles, and all shops will only allow you to buy two packets per transaction (mix and match, you can’t have 2x paracetamol and 2x ibuprofen). I believe there are some exceptions for prescriptions. Obviously you can still overdose by going to multiple stores and popping them all out of the blister packs but it puts enough of a barrier in that you have to be more determined (and more knowledgeable about what amount will actually kill you). Apparently it works.

swores 3y ago
> I believe there are some exceptions for prescriptions. You can essentially forget the maximum pill numbers for paracetamol/ibuprofen when it comes to prescriptions in the UK. Doctors can prescribe hundreds of either pill to be given to a patient at once (eg if someone is prescribed to take 8 a day and they get their meds monthly, as is the case with one paracetamol recipient I know, the pharmacy gives him multiple 100x 500mg paracetamol boxes each month.) (To be clear, "given to them at once" as in dispensing the pills, not giving to take all at once!)
mytailorisrich 3y ago
> all shops will only allow you to buy two packets per transaction They do that indeed, though I am not sure wthere it is the law of their own "do-gooder" policies. I don't think it is the law because it happened to me a few times to just pull a sad face and have the employee at the till just go "fine, but just this time". This is slightly ridiculous, IMHO: You can buy more if you want, just split transactions. And of course no-one stops you from buying a trolley-full of vodka and bleach.
- DavidPeiffer 3y ago
  >This is slightly ridiculous, IMHO: You can buy more if you want, just split transactions. And of course no-one stops you from buying a trolley-full of vodka and bleach. You can split transactions, but committing suicide takes effort, and a relatively significant rate of suicides are impulsive. For impulsive suicide, having a barrier or interruption can prevent the attempt. Something as small as a phone call interrupting you as you get the pills out could be sufficient to move past a particular impulse. There is also a huge difference in suicide attempt method depending on gender. Women tend to gravitate towards pills, while men are more likely to use a gun.
  - mytailorisrich 3y ago
    The impulse has to be to eat the tablets or whatever's on hand. Going all the way to the shop to stock up on tablets does not strike me as impulsive. So IMHO this restriction is an attempt at limiting the stock people have at home. Although I would argue this is none of the shop's business and, as far as I can gather, this is not a legal restriction.
    - jdietrich 3y ago
      It is a legal restriction and it has saved hundreds of lives. https://www.ncbi.nlm.nih.gov/books/NBK374099/ https://www.ncbi.nlm.nih.gov/books/NBK374099/
      - mytailorisrich 3y ago
        The pack size is a legal restriction, not the number of packs you can buy in one transaction as long as the total number of tablets does not exceed 100 (i.e. legal restriction is in effect 6 packs in one transaction), from what I understand, while the 2-pack restriction is a "voluntary best practice". Those 'voluntary' limitations, and there are others, are a bit of a pet peeve of mine because they strike me as hypocrisy/posturing/paternalism.
    - OJFord 3y ago
      I think the main thing is the blister pack requirement, you can't just unscrew the lid and down a bottle. Limiting to two... I don't know, it has occasionally annoyed me (when I think I want to 'stock up') but I suppose there's just no reason you actually need more than that at once (other than self-harm or with a prescription) so meh why not if it has a small chance at stopping a few suicide attempts.
    - chimprich 3y ago
      > So IMHO this restriction is an attempt at limiting the stock people have at home Correct. But this isn't a bad thing - it means people are less likely to have a large supply of dangerous pills at hand if they get a sudden urge to kill themselves or attempt a cry for help during a depressive episode. > Although I would argue this is none of the shop's business In practical terms it appears that this actually does reduce suicides and poisonings; it's a significant reduction in suffering in the world. The cost is a very small and temporary limitation on personal convenience. It's surely worth it. See also seatbelt laws. > and, as far as I can gather, this is not a legal restriction. It is in some countries, but the legal obligation is on the vendor, not the individual. If you are confident that you do need a larger cache of tablets then you can do that yourself with only minimal extra inconvenience. I think it's an elegant solution. Suicides are reduced, but the state doesn't overrule individual decision making on what their needs are.
maxerickson 3y ago
What criteria do you use to evaluate that intervention? Which really means, how do you begin to estimate the actual amount of harm reduction that it provides? Are there lots of cases where someone tried to overdose but was saved by it 'only' being 16 grams of paracetamol?
- resolutebat 3y ago
  The grandparent of the post you're responding to provides stats showing that suicides/overdoses with OTC painkillers went down markedly after the change.
- jdietrich 3y ago
  The number of deaths due to paracetamol poisoning fell by 22% in the year after the legislation. There was no significant increase in suicide deaths by other means. We see similar results with interventions like reducing the availability of highly toxic pesticides or installing barriers on bridges. Most suicidality is impulsive and transient, so simple interventions to reduce access to means of suicide can have very significant results. There's very little you can do to prevent a sufficiently determined person from dying by suicide, but most people who die by suicide aren't strongly motivated to die - they're just briefly overwhelmed by life. https://www.bmj.com/content/329/7474/1076 https://www.bmj.com/content/329/7474/1076 https://www.hsph.harvard.edu/means-matter/means-matter/saves-lives/ https://www.hsph.harvard.edu/means-matter/means-matter/saves...
- tmp1543279 3y ago
  I'm on an alt account here for obvious reasons. I can only speak from my experience, but at one point I took all the paracetamol I had (suicidal and pretty drunk, the taste of cheap red wine and paracetamol is... unpleasant to say the least). I ended up fine after a friend forced me to go to the hospital the next day. If I had more tablets around, I would have taken them too. So it likely wouldn't stop someone who planned to kill themselves, however with me anyway not having like 100 tablets around did help due to it being impulsive enough. It might have been quite a big difference due to how long after the fact I went to the hospital, I took quite a lot but it had done little enough damage that some medicine in my arm over the course of about a day and having to avoid alcohol and paracetamol for a while was enough to fix it. I imagine a lot of cases are quite similar to mine and it probably did make quite a big difference with me as I only had 2 boxes around and one wasn't completely full.

swores 3y ago

> I believe there are some exceptions for prescriptions. You can essentially forget the maximum pill numbers for paracetamol/ibuprofen when it comes to prescriptions in the UK. Doctors can prescribe hundreds of either pill to be given to a patient at once (eg if someone is prescribed to take 8 a day and they get their meds monthly, as is the case with one paracetamol recipient I know, the pharmacy gives him multiple 100x 500mg paracetamol boxes each month.) (To be clear, "given to them at once" as in dispensing the pills, not giving to take all at once!)

mytailorisrich 3y ago

> all shops will only allow you to buy two packets per transaction They do that indeed, though I am not sure wthere it is the law of their own "do-gooder" policies. I don't think it is the law because it happened to me a few times to just pull a sad face and have the employee at the till just go "fine, but just this time". This is slightly ridiculous, IMHO: You can buy more if you want, just split transactions. And of course no-one stops you from buying a trolley-full of vodka and bleach.

DavidPeiffer 3y ago
>This is slightly ridiculous, IMHO: You can buy more if you want, just split transactions. And of course no-one stops you from buying a trolley-full of vodka and bleach. You can split transactions, but committing suicide takes effort, and a relatively significant rate of suicides are impulsive. For impulsive suicide, having a barrier or interruption can prevent the attempt. Something as small as a phone call interrupting you as you get the pills out could be sufficient to move past a particular impulse. There is also a huge difference in suicide attempt method depending on gender. Women tend to gravitate towards pills, while men are more likely to use a gun.
- mytailorisrich 3y ago
  The impulse has to be to eat the tablets or whatever's on hand. Going all the way to the shop to stock up on tablets does not strike me as impulsive. So IMHO this restriction is an attempt at limiting the stock people have at home. Although I would argue this is none of the shop's business and, as far as I can gather, this is not a legal restriction.
  - jdietrich 3y ago
    It is a legal restriction and it has saved hundreds of lives. https://www.ncbi.nlm.nih.gov/books/NBK374099/ https://www.ncbi.nlm.nih.gov/books/NBK374099/
    - mytailorisrich 3y ago
      The pack size is a legal restriction, not the number of packs you can buy in one transaction as long as the total number of tablets does not exceed 100 (i.e. legal restriction is in effect 6 packs in one transaction), from what I understand, while the 2-pack restriction is a "voluntary best practice". Those 'voluntary' limitations, and there are others, are a bit of a pet peeve of mine because they strike me as hypocrisy/posturing/paternalism.
  - OJFord 3y ago
    I think the main thing is the blister pack requirement, you can't just unscrew the lid and down a bottle. Limiting to two... I don't know, it has occasionally annoyed me (when I think I want to 'stock up') but I suppose there's just no reason you actually need more than that at once (other than self-harm or with a prescription) so meh why not if it has a small chance at stopping a few suicide attempts.
  - chimprich 3y ago
    > So IMHO this restriction is an attempt at limiting the stock people have at home Correct. But this isn't a bad thing - it means people are less likely to have a large supply of dangerous pills at hand if they get a sudden urge to kill themselves or attempt a cry for help during a depressive episode. > Although I would argue this is none of the shop's business In practical terms it appears that this actually does reduce suicides and poisonings; it's a significant reduction in suffering in the world. The cost is a very small and temporary limitation on personal convenience. It's surely worth it. See also seatbelt laws. > and, as far as I can gather, this is not a legal restriction. It is in some countries, but the legal obligation is on the vendor, not the individual. If you are confident that you do need a larger cache of tablets then you can do that yourself with only minimal extra inconvenience. I think it's an elegant solution. Suicides are reduced, but the state doesn't overrule individual decision making on what their needs are.

maxerickson 3y ago

What criteria do you use to evaluate that intervention? Which really means, how do you begin to estimate the actual amount of harm reduction that it provides? Are there lots of cases where someone tried to overdose but was saved by it 'only' being 16 grams of paracetamol?

resolutebat 3y ago
The grandparent of the post you're responding to provides stats showing that suicides/overdoses with OTC painkillers went down markedly after the change.
jdietrich 3y ago
The number of deaths due to paracetamol poisoning fell by 22% in the year after the legislation. There was no significant increase in suicide deaths by other means. We see similar results with interventions like reducing the availability of highly toxic pesticides or installing barriers on bridges. Most suicidality is impulsive and transient, so simple interventions to reduce access to means of suicide can have very significant results. There's very little you can do to prevent a sufficiently determined person from dying by suicide, but most people who die by suicide aren't strongly motivated to die - they're just briefly overwhelmed by life. https://www.bmj.com/content/329/7474/1076 https://www.bmj.com/content/329/7474/1076 https://www.hsph.harvard.edu/means-matter/means-matter/saves-lives/ https://www.hsph.harvard.edu/means-matter/means-matter/saves...
tmp1543279 3y ago
I'm on an alt account here for obvious reasons. I can only speak from my experience, but at one point I took all the paracetamol I had (suicidal and pretty drunk, the taste of cheap red wine and paracetamol is... unpleasant to say the least). I ended up fine after a friend forced me to go to the hospital the next day. If I had more tablets around, I would have taken them too. So it likely wouldn't stop someone who planned to kill themselves, however with me anyway not having like 100 tablets around did help due to it being impulsive enough. It might have been quite a big difference due to how long after the fact I went to the hospital, I took quite a lot but it had done little enough damage that some medicine in my arm over the course of about a day and having to avoid alcohol and paracetamol for a while was enough to fix it. I imagine a lot of cases are quite similar to mine and it probably did make quite a big difference with me as I only had 2 boxes around and one wasn't completely full.