Article Data

  • Views 1312
  • Dowloads 204

Original Research

Open Access

Trends in drug poisoning of youth patients after the deregulation of over the counter drug sales

  • Ji Yeon Lim1,*,
  • Sun Hwa Lee2
  • Duk Hee Lee2

1Department of Emergency Medicine, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, 07804 Seoul, Republic of Korea

2Department of Emergency Medicine, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, 07985 Seoul, Republic of Korea

DOI: 10.22514/sv.2023.078 Vol.19,Issue 6,November 2023 pp.60-66

Submitted: 15 January 2023 Accepted: 28 March 2023

Published: 08 November 2023

*Corresponding Author(s): Ji Yeon Lim E-mail: beautifuldoctor@gmail.com; 01242s@eumc.ac.kr

Abstract

Since 15 November 2012, the South Korean government amended the law to make some medicines available at 24-hour convenient stores that had previously been sold at pharmacies only. The aim of this study was to evaluate the impact of this legislation on drug poisoning in youth patients, who may be affected by increased access. This study retrospectively analyzed data registered in the Emergency Department-based Injury In-depth Surveillance (EDIIS) database from January 2007 to December 2018. Patients aged 15 to 24 years old were selected to analyze the incidence and outcomes of acetaminophen (AAP) poisoning in youth patientsBefore the deregulation of over-the-counter (OTC) medication sales, 1994 youth patients visited the emergency department (ED) from 2007–2012. By contrast, 5440 youth visited the ED from 2013–2018 after deregulation. In particular, there were 263 (13.2%) and 820 (15.1%) cases of AAP poisoning intentionally before and after deregulation, respectively, which was not significantly different (p = 0.085). However, the number of patients who were admitted to the general ward (GW) due to AAP poisoning significantly increased from 93 (35.4%) to 339 (41.3%) (p = 0.041). Furthermore, the number of patients who were admitted to the intensive care unit (ICU) after ingesting AAP significantly increased from 9 (3.4%) to 93 (11.3%) (p < 0.001).There was no significant difference in intentional AAP poisoning ratios following the deregulation of OTC drug sales; however, GW and ICU admission rates significantly increased. This study demonstrated that there is positive relationship between intentional AAP poisoning and severity in youth patients after the deregulation legislation.


Keywords

Acetaminophen; Adolescent; Emergency department; Nonprescription drug; Poisoning


Cite and Share

Ji Yeon Lim,Sun Hwa Lee,Duk Hee Lee. Trends in drug poisoning of youth patients after the deregulation of over the counter drug sales. Signa Vitae. 2023. 19(6);60-66.

References

[1] Spiller HA, Ackerman JP, Spiller NE, Casavant MJ. Sex- and age-specific increases in suicide attempts by self-poisoning in the united states among youth and young adults from 2000 to 2018. The Journal of Pediatrics. 2019; 210: 201–208.

[2] Hayden JC, Kelly L, McNicholas F. A clinician’s guide to self-poisoning with paracetamol in youth: the what, when and why? Acta Paediatrica. 2020; 109: 2237–2242.

[3] O’Rourke M, Garland MR, McCormick PA. Ease of access is a principal factor in the frequency of paracetamol overdose. Irish Journal of Medical Science. 2002; 171: 148–150.

[4] Grimmond J, Kornhaber R, Visentin D, Cleary M. A qualitative systematic review of experiences and perceptions of youth suicide. PLOS ONE. 2019; 14: e0217568.

[5] Orri M, Scardera S, Perret LC, Bolanis D, Temcheff C, Séguin JR, et al. Mental health problems and risk of suicidal ideation and attempts in adolescents. Pediatrics. 2020; 146: e20193823.

[6] World Health Organization (WHO). Suicide. 2019. Available at: https://www.who.int/news-room/fact-sheets/detail/suicide (Accessed: 25 July 2021).

[7] Eaton DK, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, et al. Youth risk behavior surveillance—United States, 2007. MMWR Surveillance Summaries. 2008; 57: 1–131.

[8] Center KSP. Suicide prevention white paper. Korea Suicide Prevention Center: Seoul. 2020.

[9] Statistics Korea (KOSTAT), Ministry of Gender Equality and Family (MOGEF). The report of the Korean adolescent in 2020. 2020. Available at: http://kostat.go.kr/assist/synap/preview/skin/doc. html?fn=synapview381815_1&rs=/assist/synap/preview (Accessed: 25 July 2021).

[10] Hong JP, Choi SH. Korea Annual Report of Suicide (Report NO.: ISSN 2508–2485). Seoul: 2021 July.

[11] Kim H, Kim B, Kang S-G, Kim M-D, Kim M-H, Kim S-I, et al. Attempted suicides in South Korea: a multi-center analysis of causes, methods, and psychiatric diagnoses of suicidal attempters in 2013. Korean Journal of Biological Psychiatry. 2015; 22: 187–194.

[12] Min SJ, Park EJ, Kim HH, Min YG. Characteristics of adjustment disorder patients as suicidal attempters visited emergency department: significance of adjustment disorder and suicide. Journal of the Korean Society of Emergency Medicine. 2016; 27: 595–601.

[13] Ko SH, Lee KW. Clinical analysis of acute drug poisoning victims by intentional poisoning. The Journal of Emergency Medicine. 2012; 43: 935–936.

[14] Park JH, No YH, Wi DH. Clinical analysis of attempted suicide in the elderly. Journal of the Korean Society of Emergency Medicine. 2001; 12: 135–142.

[15] Hawton K, Saunders KE, O’Connor RC. Self-harm and suicide in adolescents. The Lancet. 2012; 379: 2373–2382.

[16] Inglis JHC. Restricting sales of paracetamol tablets: effect on deaths and emergency admissions for poisoning in Scotland 1991–2002. Scottish Medical Journal. 2004; 49: 142–143.

[17] Jung KY, Kim T, Hwang SY, Yoon H, Shin TG, Sim MS, et al. Availability of drug at convenient stores is not associated with an increased incidence of their poisoning. Pharmacoepidemiology and Drug Safety. 2019; 28: 536–543.

[18] Caudron M, Gosselin-Papadopoulos R, Jamoulle O, Swaleh S, Taddeo D, Frappier J. Characteristics and trends in intentional acetaminophen intoxication in adolescents over two decades. Paediatrics & Child Health. 2016; 21: e93.

[19] Korea national statistical office. Daejeon: annual report on the cause of death statistics of 2018; 2018. Available at: http://kostat.go.kr/portal/korea/index.action (Accessed: 25 July 2021).

[20] Marzec I, Zabłocka K, Stachurski J. Suicide attempts in children and adolescents—risk factors, methods and management of suicidal patient. Pediatria Polska—Polish Journal of Paediatrics. 2021; 96: 1–8.

[21] Gedeborg R, Svennblad B, Holm L, Sjögren H, Bardage C, Personne M, et al. Increased availability of paracetamol in Sweden and incidence of paracetamol poisoning: using laboratory data to increase validity of a population-based registry study. Pharmacoepidemiology and Drug Safety. 2017; 26: 518–527.

[22] Prior MJ, Cooper K, Cummins P, Bowen D. Acetaminophen availability increases in Canada with no increase in the incidence of reports of inpatient hospitalizations with acetaminophen overdose and acute liver toxicity. American Journal of Therapeutics. 2004; 11: 443–452.

[23] Kim CY, Lee EJ, Lee SW, Kim SJ, Han KS. Changes in toxicological characteristics after sales of nonprescription drugs in convenience stores. Journal of the Korean Society of Clinical Toxicology. 2018; 16: 42–48.

[24] Kim SH, Kim H, Lee JS, Park J, Kim KH, Shin DW, et al. Pharmaceutical drug poisoning after deregulation of over the counter drug sales: emergency department based in-depth injury surveillance. Journal of the Korean Society of Clinical Toxicology. 2018; 16: 141–148.

[25] Squires Jr RH, Shneider BL, Bucuvalas J, Alonso E, Sokol RJ, Narkewicz MR, et al. Acute liver failure in children: the first 348 patients in the pediatric acute liver failure study group. The Journal of Pediatrics. 2006; 148: 652–658.e652.

[26] Jo SJ, Gang HY, Lee SJ, Bae GH, Lee EJ, Han KS, et al. Continuous control of acetaminophen poisoning after implementation of regulation for ease access of acetaminophen: cohort study from emergency department based in-depth injury surveillance. Journal of the Korean Society of Clinical Toxicology. 2020; 18: 57–65.



Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top