SELF-POISONING IN NEWCASTLE, 1987-1992

Objective: To examine the morbidity and mortality associated with self -poisoning with different drug classes. Design: Prospective cohort stu dy with limited follow-up. Retrospective analysis of coronial data. Se tting: Primary and tertiary referral toxicology centre covering Newcas tle and Lake Macquarie, Australia, 1987-1992. Results: There were 1969 admissions after ingestion of 3724 substances (2424 prescription drug s and 1300 non-prescription items). The coroner investigated 83 drug-r elated deaths. Only 12 of these people presented to hospital and, for most of these, death was inevitable at presentation. The most frequent ly ingested substances were benzodiazepines, alcohol, paracetamol, ant idepressants, neuroleptics and anticonvulsants. Since 1980, the percen tage of self-poisonings involving benzodiazepines has fallen, while it has risen for those involving antidepressants. Over 50% of deaths wer e due to tricyclic antidepressants or opioid analgesics. Conclusions: As death usually occurs out of hospital, interventions to decrease mor tality from self-poisoning must focus on prevention, and targeting dru gs that are frequently taken or frequently lethal in overdose. Conside ration should be given to the use of antidepressants that are safer in overdose. The use of antidepressants, barbiturates or chloral hydrate as sedatives should be discouraged.