ABSTRACT
Self-poisoning creates 10% of the workload of Accident and Emergency departments in the UK. Opioids (diamorphine (heroin), morphine and methadone), compound analgesics (e.g. codeine plus paracetamol), paracetamol alone and antidepressants are the most common drugs used in fatal overdose. Temazepam, cocaine, MDMA/ecstasy, lithium, paraquat, salicylates, digoxin and aminophylline continue to cause fatalities. This list of agents that cause death from overdose does not reflect the drugs on which individuals most commonly overdose. Self-poisoning often involves multiple drugs and alcohol. Benzodiazepines (often taken with alcohol) are commonly taken in an overdose, but are seldom fatal if taken in isolation. Around 75% of deaths from overdose occur outside hospital, with the mortality of those treated in hospital being less than 1%. The majority of cases of self-poisoning fall into the psychological classification of suicidal gestures (or a cry for help). However, the prescription of potent drugs with a low therapeutic ratio can cause death from an apparently trivial overdose.
