| These are great questions. They're normally pretty good at responding if you want more information. Here "patient" means "under the care of secondary MH services", so doesn't include people who are being treated by their GP rather than by eg a community MH team. I think the opioid / APAP stuff is based on bots of history. Co-Proxamol was for years the most common med used in completed suicide. It was put on more restrictive prescribing, and use dropped. But then plain paracetamol use in completed suicide increased. (And also attempted suicide, for a while paracetamol overdose was 4% of UK liver transplants, (but 25% of the super-urgent transplants)). Rules about paracetamol tightened, so we've seen reductions in its use. So, from a public health POV, it's useful to see if plain paracetamol, or the combination, or plain opioids are being used more often, because that means they can look at what's driving sales or prescriptions. About safe prescribing: one source of medication used in completed suicide is either from your own prescription, or from a relative's prescription. This is often a preventable cause of death, so it's useful to see if safe prescribing helps. It ties into things like "Triangle of Care" and also "Pills Project" (which I want to try to use outside care homes). You're right about older people. They also often don't lock up the meds in a cupboard (they don't have children in the home anymore, they don't see a need) and tragically grand-children come to visit and accidentally overdose. https://www.carers.org/triangle-care http://www.health.org.uk/pills |