A descriptive study of intentional self‐poisoning from New Zealand national registry data

Abstract

Objective: Understanding which population groups intentionally poison themselves by overdose and which substances are used are key to developing prevention efforts for such injuries. This paper uses Ministry of Health (MOH) data to explore the demographic characteristics of those who intentionally self-poison and the substances used, identifies limitations of existing data collections and makes recommendations for the future. Methods: MOH mortality data from 2000 to 2012, and public hospital presentation data from 2000-2014 of cases of intentional self-poisoning (ISP), and poisoning of undetermined intent (UDP), were examined. Results: Men were more at risk of fatal intentional poisonings, while young women and people from deprived areas were predominant in hospital presentations for ISP and UDP. While ICD-10 categories were available, there was limited information in the majority of MOH data about specific substances used in the poisonings. Conclusions:The current format of MOH data indicates that developing interventions to help young people and those living in deprived areas may be useful. Finding specific solutions is challenging when only limited nationwide substance-specific poisoning information is available. Implications for public health: Including specific substances in national data collections is important for addressing the public health challenge of intentional overdose morbidity and mortality.

Incidence of Intoxication Events and Patient Outcomes in Taiwan: a Nationwide Population-based Observational Study

“…However, our examination of patients with severe intoxication indicated that sex was unrelated to survival. The incidence of severe intoxication among different age groups also varied in previous studies (17,23,27). We found that elderly patients were more likely to die from severe intoxication.…”

“…Our overall in-hospital mortality rate was much higher than reported in other countries (Taiwan: 2.6%, other countries: 0.1-1.3%), as was our mortality rate from severe intoxication (Taiwan: 21.6%, other countries: 2-9%) (1, 2, 14, 15). The most likely reason is the higher proportion of severe intoxication events or greater severity of intoxication in our population (5)(6)(7)(8)(9)(10)(11)(12)(13)(16)(17)(18). Our mean ICU stay (3 days) and hospital LOS (7 days) was longer than reported in studies from The Netherlands and Hong Kong (ICU: 0-1.3 days; hospital LOS: 1-3 days) (14,18,19).…”

Prescribers aware: a cross-sectional study from New Zealand emergency departments on the substances used in intentional self-poisoning and their sources

“…These codes record broad groups of medicines, but not specific substances. 2 Further, there is no information collected on how or where the substance was obtained. International evidence suggests that ease of access is key to substance selection in intentional selfpoisoning, and although people may choose to take medicines prescribed to someone else if they gain access, most use their own prescribed medicines.…”

Stocks of paracetamol products stored in urban New Zealand households: A cross-sectional study

“…Intentional self-poisoning (ISP) where too much of a medication or other substance is taken by a person for the purpose of self-harm is a common type of injury treated in Emergency Departments in New Zealand, with paracetamol (acetaminophen) commonly involved [1]. Paracetamol is commonly encountered in exposures also in, for example, Australia [2][3][4], Ireland [5][6][7], England [8], Canada [9,10], and the United States [11].…”

“…Poisoning fatalities in general occur at an annual rate of 7.1/100,000 population in New Zealand, and 71% of them are intentional [12]. Hospital admissions due to poisoning occur at an annual rate of 115.4/ 100,000 in New Zealand, and again 65% of such presentations are due to ISP [12], with an annual rate of 70.86 hospital presentations per 100,000 population for suspected ISP [1]. Rates of hospital presentations may not be directly comparable internationally due to differences in definitions and methodologies, e.g.…”