AN ANALYSIS of clinical toxicology specialist referrals from the NSW Poisons Information Centre (PIC) has revealed a high burden of disease from intentional self-harm, particularly with commonly accessible substances like paracetamol and other non-opioid analgesics.
The team looked at over 600,000 calls received by the NSW PIC between 2017 and 2022, of which 12,475 (1.9%) were considered complex or severe enough to escalate to clinical toxicologists for more expert input.
Paracetamol was the most frequently reported substance in referred calls (14%), followed by ethanol (10%), quetiapine (8%), snakebite (6%) and diazepam (5%).
The most common categories of drug poisonings included non-opioid analgesics (22%), antidepressants (20%), atypical antipsychotics (14%), and opioids (8%).
More than half (53.4%) were considered deliberate self-poisoning, 18% accidental exposure, 7% adverse reactions, 5% recreational and 5% therapeutic error.
The team observed that from 2017 to 2022, the proportion of NSW PIC calls referred to clinical toxicologists increased from 1.5% to 1.9%, "which possibly reflects a growing need for toxicologist input", they suggested.
The median age of callers was 32, consistent with the finding that young adults are more frequently involved in deliberate self-poisoning incidents, and just over half (53.7%) were women.
They also noted a summer peak, likely influenced by higher risk of snake bites and exposures linked to festive activities.
"By identifying these referral patterns, the study establishes a foundation for future research aimed at improving clinical management guidelines and developing public health and education initiatives to prevent poison exposures," the authors wrote in Emergency Medicine Australasia - read the paper HERE.
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