Guest post: "It's too easy for our daughter to self-harm with paracetamol"

[MumsnetGuestPosts]

At the age of 12, our daughter seemed to be holding life in her hands - she was bright and articulate, a social butterfly. Then, she overdosed. Our world and hers came crashing down.

Unbeknownst to us or her teachers, our youngest child had been systematically bullied for over a year. Older boys targeted her, calling her names and spitting in her hair. Having always been taught to be resilient, she'd tried to ride the storm single-handedly, hoping that ignoring the bullies would make them stop. Sadly, as her mental health began to deteriorate, her close circle of friends dispersed - perhaps for reasons of self preservation, they united with the bullies. Left alone to face the daily tirade of abuse, she no longer had the strength to continue.

Our daughter’s chosen drug of harm is paracetamol. It is cheap enough to be accessible with pocket money, and with no legal restrictions with regard to selling to children, it can be bought without challenge. This seemingly innocuous painkiller is a potent drug that can cause irreversible organ damage - and death - in relatively small doses. It is a hepatotoxin; as it is processed by the body, it starts to destroy the cells of the liver. It can take days for the person who has overdosed on paracetamol to feel unwell. By this point they may be reaching the end of the three-day window when the antidote will work - and they may have changed their mind about wanting to cause themselves lasting damage. However, after this point, no amount of medical intervention bar a liver transplant can help, and liver damage or an incredibly painful death ensues.

Through a tumultuous and terrifying four year journey with our daughter, we have learnt that numerous overdoses haven't signalled a yearning to end her own life. She only wishes to quieten the raging torrent in her mind and find a modicum of relief.

At the beginning of this summer we were confident that our child was about to enter a new chapter of her life. She had secured a college place for September - no mean feat when you haven’t attended school since Year Eight and have only sporadically accessed home tutoring due to mental health. We were hopeful that a fresh start in further education would be the challenge she needed to focus on something positive.

Last week, I realised this was all in jeopardy. The phone rang and I picked up, expecting to hear my daughter on the other end. I answered in my best Scottish accent, angling for a cheap laugh. Instead it was her dad: “You need to get here,” he said. “She’s slashed her arm with a Stanley knife.” Instantly my hand shook, my stomach dropped and I found it hard to find my own voice, let alone an accent.

After a long, calm summer, careless words from a friend have sent my daughter's mental health spiralling. Although the friend has since apologised, our daughter is still visibly wilting before our eyes. She is hellbent on harming herself to appease her demons - I am hellbent on stopping her.

Every minute is spent closely watching her, monitoring her mental health. She cannot bath or shower unsupervised, nor can she be left alone in her bedroom or even have access to her own money. We have to take these rights away from her to keep her safe. Past history suggests that, finding no relief from cutting herself, my daughter’s next attempt will be to self-poison, the Russian roulette of self-harm.

We hope this won’t happen, but out of my sight I know how simple it would be for her to access paracetamol - and she’s by no means the only one. Of children under 15 presenting to hospital after deliberate overdose, more than 50% had taken paracetamol. It is shocking that so many young people are able to harm themselves so easily. It frightens and enrages me that the government won't review the current legislation that does not restrict paracetamol sale to minors - which is why I am currently raising awareness and accruing public support to try to change this.

As for our personal journey - every day shows me just how determined my daughter is. Yesterday, I bought her, as requested, a set of sparkly emery boards. Today she has no skin left on her knuckles. Today I learnt another lesson. Where self-harm is concerned, it is so difficult for parents to protect our children from themselves - we need what help we can get, and legislating on paracetamol sales is a necessary first step.

Vikki Harris is calling on the government to restrict paracetamol sale to minors - you can sign her petition here.

[Torrtty]

24g of Paracetamol is generally accepted to be a fatal dose. The lowest amount of Paracetamol to cause death was found by one study to be 10g. As for Paracetamol of 500mg per tablet, it is generally recommended to take no more than 8 tablets (500mg) within 24 hours, and 24 to 30 tablets taken at one time can lead to overdose or even death.
Not sufficient time between doses or high amount of tablets taken at one time may lead to a fatal overdose.Side effects of an overdose may be seen after ingesting around 4-6g, although this is dependent upon an individual's physiological make-up and metabolism.

[MotherOfDragons27]

I'm so sorry for what your daughter is going through. I work for Asda and yes, Paracetamol and products containing paracetamol (even Calpol) is age restricted to over 16s and limited to two products at a time.

[AndNowItsSeven]

Totally agree, paracetamol is 16p in our local supermarket! Dd can buy paracetomal but not false nails which are age restricted ( due to the tiny tube of glue)

[AndNowItsSeven]

Battersie you are wrong , depressed teens can also be very underweight. If you way around six stones you don't need many tablets to be fatal.

[BeautyGoesToBenidorm]

Paracetamol is unbelievably toxic, even in relatively small overdoses. Does anyone else remember a story from a few years ago, where a young woman with the flu died from liver failure after overdosing - unknowingly - from a combination of paracetamol tablets and Lemsip flu sachets? If I remember rightly, it took a week from her taking the meds, to dying.

Paracetamol in tablet form is restricted, paracetamol in powder form isn't. I believe that very clear notices should be visible in all shops selling it, and that shop staff should also be made aware of the risks. Very often, customers don't realise that they may be overdosing.

[QuestionableMouse]

I've been asked for ID within the last week before I could buy painkillers.

Honestly, I don't think restricting the sale of painkillers is the way to go.

[Dozer]

I'm very sorry your daughter is so unwell and has been through all that, and for your family too.

I'd be interested in the authorities' rationale for the current arrangements. It does seem easy for DC to both deliberately self harm in this way, and to have accidents. Knives, for example, can only be sold to over 16s.

Not the main point, but you seem angry with the friend you mention and imply that your DD's "relapse" was caused by the friend's comments. This seems unlikely given your DD's MH problems.

[Albadross]

How tough that must be - and especially difficult to be dealing with the immediate aftermath of her cutting when you're trying to fathom how she can hurt the body you made in that way. Unfortunately we do have to be honest about this stuff - and that includes acknowledging that if someone really wants to harm themselves, they will find a way. I hope you have support for your own mental health too?

I've struggled with self harm for all of my life since I was 13, and despite having taken over 20 paracetamol a day for almost a decade, no doctor has ever seen fit to do more than the basic liver function bloods. I've been extremely lucky so far. Even after I'd stopped using co-codamol to harm I was stuck taking it because no matter how much I begged I couldn't get codeine on its own prescribed. I campaigned for the addition of the 3 day warning on over the counter codeine and eventually that was added so people were aware of the physical dependency risks.

More education is needed on this - children at school should learn how to safely take medication for small aches and pains and warned of the risks to prevent accidental OD but as other posters say I thought it already was restricted to over 16s in most shops. Even if she was refused a sale in one shop wouldn't she simply go to another?

[Hamsolo]

I'm genuinely surprised that sales aren't restricted for younger children. If you had asked me I would have assumed that paracetamol/ ibuprofen etc weren't available to under 16s except from their parents, and I think really that's sensible. I wouldn't be sure that a 10 or 12 year old could dose themselves correctly or understood the dangers of accidental overdose. Previous posters are right that a truly determined person will find other ways, but I still think there's a good argument for age restriction on medication. Paracetamol is not a "safe" drug, though it seems innocuous. It's pretty easy to do accidental damage by taking it incorrectly, let alone through deliberate misuse.

[Torrtty]

Ultimately my daughter is responsible for her own safety and I blame no one other than perhaps the spiteful bullies who caused her demise. I think perhaps you're missing the point, if nothing else my post has raised awareness to the dangers of paracetamol which is ultimately what I set out to do.
We are now off with my daughter to a festival for the weekend where we will keep her safe and build memories but thank you for your parenting tips and opinions!😘

[megletthesecond]

I'm shocked that there aren't tighter restrictions and have signed and will share. My teenage years were a catalogue of depression, bullying and self harm, I remember it well.

Have a nice time at the festival.

[StringersBellend]

It seems like you're externalising, infantalising and victimising. Your DD is a victim of bullies who made her self-harm, she is at risk of poisoning because paracetamol is too available, she can't have basic freedom because she might hurt herself.

This stuff is all coming from inside your DD at the end of the day, not being inflicted on her by external forces. The more you make her adopt the "sick role" the less independent she will be.

I have seem teens put through the psychiatric system, repeatedly hospitalised, eventually falling into a behaviour pattern that becomes the norm with everyone running around to wrap them in cotton wool. And then they become adults in the psych system who never get out. They often learn new ways to self-harm from the internet and from other patients and become more entrenched in playing the part of their illness.

Losing normality like school and college means that their whole identity becomes the illness. The family is obsessed with it and it becomes a circus. It's hard for the child to change and grow out of the self-harm.

Sometimes it's necessary to tolerate the self-harm until the child begins to learn new coping mechanisms, rather than confiscating everything all the time. As you've seen, taking away one method just leads to the child picking up another. Paracetamol is obviously a problem because suicide can be achieved without true intent, as it's so toxic. But if all the blades are confiscated then she will go looking for it again, and if the shop won't sell it she will steal it or find one that will.

I know this from experience.

She needs coping mechanisms that, for the moment, might be painful in some way (scratching, cutting, holding on to ice, snapping elastic bands on the wrist) until she can develop them into something non-harmful with maturity. Self-harm is like an addiction and it's very hard to break. The internet is full of forums of "cutters" trying to give up cutting themselves one day at a time, and they often relapse in the process.

Most modern psych services will not advocate micro-managing the self-harm and obsessively confiscating everything. The focus is on keeping wounds clean and using clean implements.

I hope you have sufficient family support, as often self-harm is a family disease, like any addiction, and must be worked through in a coherent and comprehensive fashion with all family members in therapy.

[StringersBellend]

Oh and my first pack of razor blades was stolen from a shop. The age limit definitely would not have stopped me. You can also buy disposable razors and pick the blades out.

[Batteriesallgone]

externalising, infantalising and victimising

That's what jumped out at me that I inarticulately tried to address.

The OP seems to be pouring energy into this sideshow rather than researching safe self harming and the best way to deal with her daughters behaviour.

Crying together post self harm isn't helpful. Self harm is generally a release tool that make people feel temporarily better. Being encouraged to have a good cry after is pretty harmful I'd have thought - I wonder if the tears are a function of the guilt the OPs daughter is being made to feel for harming.

[StringersBellend]

Immediately after self harming my daughter will seek me out to be held and soothed until her tears dry and if we can't tend to her wounds ourself our local 24 hour emergency unit will help, again she is never judged but treated with dignity and respect. *

And you wonder why she keeps self harming?!

[StringersBellend]

Batteries, I totally agree. The whole family is centered around the self harming child.

Any act of self harm results in care and attention far disproportionate to what is actually need.

She will likely never grow out of this without some serious psychological therapy for the family to analyse the maladaptive dynamic here.

[BlackDoglet]

I am really sorry you and your family are going through this and I hope you can find the support you need.

Both Sainsbury's and Asda around here already age check you for paracetamol; as do Boots, Superdrug and the independent pharmacies.

[OlennasWimple]

I've never been IDed buying paracetamol! Maybe I look so far over 16 or 18 that it's not necessary...

I have, however, been prevented from buying paracetamol because I shopping with my dad, we both needed painkillers but the assistant refused to sell us two packets in the same transaction. And then when we split them into two separate transactions we were still refused, because she now knew that we were together

I told my American friends this story, and they laughed incredulously - you buy paracetamol and ibruprofen in tubs of 1000 here...

[SherlockPotter]

I will never understand why there isn't an enforceable age limit (it may say over 16's but how many shops actually ID the customers?) on an easily accessible drug like paracetamol which can cause damage that can be irreversible or even fatal. I will sign it and share it with my friends and family to sign.

I have no words but my thoughts are with you and your family!

[anotherdayanothersquabble]

OP, sorry you are coming under fire. I wanted to stand in your corner and say I understand, wish you and your family the very best without judgement criticism or comment.

[Hmmnotkeen]

I think this is a very bad idea for a guest post, MN.

[Purplebluebird]

So sorry to hear this,what a difficult time for you all. I am surprised this is not age restricted, I really thought it was.

For the self harm - I was like your daughter. It's actually a tool to cope with psychological pain, and I don't think you should restrict it so much. Yes, she must not be able to take pills, or harm herself seriously, but at least for me, self harm made it possible to live. It really did help for a while. I think as she gets help and better tools to cope with things, it will get easier, and she will eventually stop the self harm obsession. I wish you the best x

[Blueshoessingloose]

Restricting young girls ability to get painkillers when they have their period is not going to protect a suicidal child. The suicidal tendendancies were caused by bullying, a very real problem that drives many youngsters to attempt suicide through various means, hanging, wrist slitting drowning, jumping under a train.... So why not have a campaign to protect children from being driven to despair in the first place? No child should experience that, all should be protected, it should be the law that schools, bullies and parents of bullies are held legally accountable. Then kids won't be driven to this in the first place.