The use of analgesics for intentional self-poisoning: Trends in U.S. poison center data

In the U.S., intentional self-poisonings with analgesics that are available without a prescription increased from 2000 to 2018. Given concerns regarding mental health outcomes during the COVID-19 pandemic, we examined and compared trends in pediatric and adult intentional self-poisoning with acetaminophen, aspirin, ibuprofen, and naproxen from 2016 to 2021 using the National Poison Data System (NPDS) to see if these trends have continued. We extracted annual case counts of all suspected suicide attempts from intentional poisoning, and of suspected suicide attempts resulting in major effects or death, from the NPDS for non-prescription single ingredient adult formulation acetaminophen, non-prescription single ingredient adult formulation aspirin, single ingredient formulation ibuprofen, and single ingredient formulation naproxen. We enumerated the cases by year, age, and gender. Most cases of intentional self-poisoning within the review period involved acetaminophen and ibuprofen and the 13-19-year-olds constituted the highest proportion of intentional self-poisoning cases across age groups for all four analgesics. Cases involving females predominated cases involving males by 3:1 or greater. The 13-19-year-old age group also represented the largest proportion of cases that resulted in major clinical effects or deaths. An increasing trend in suicide poisoning cases with acetaminophen and ibuprofen was observed in the 6-19-years age group and this trend appeared to exacerbate from 2020 to 2021 corresponding with the start of the COVID-19 pandemic period.