Liver failure induced by paracetamol.

among the 119 recorded as dying in 1990 or how many would not have taken an overdose had they been aware that paracetamol, if taken in large quantities, often results in a painful and lingering death due to liver failure.By diverting attention towards the 1143 deaths due to overdose of drugs other than paracetamol Spooner disregards the fact that paracetamol is consistently one of the most common drugs used in suicide and far exceeds any other over the counter medication as a method of death by poisoning.It is also by far the most common substance used in deliberate self poisoning attempts.In a review of 3263 admissions after deliberate self poisoning in South West Thames region in 1989 I found that 957 were a result of paracetamol overdose (unpublished study).The next most common class of drugs used was benzodiazepines, which accounted for 584 admissions.Benzodiazepines, of course, are prescription only drugs, and an overdose is far less likely to cause death.Combining paracetamol with methionine, as Bray suggests, may not be the answer, but surely the manufacturers of paracetamol should take a more responsible attitude by at least placing a more specific warning of the effects of overdose on the packaging.