Monday, June 03, 2013


Dr Ezekiel Emanuel notes that suicides, including suicides by poisoning, have been on the rise in recent years, and in response he makes a perfectly rational proposal:
We need to make it harder to buy pills in bottles of 50 or 100 that can be easily dumped out and swallowed. We should not be selling big bottles of Tylenol and other drugs that are typically implicated in overdoses, like prescription painkillers and Valium-type drugs, called benzodiazepines. Pills should be packaged in blister packs of 16 or 25. Anyone who wanted 50 would have to buy numerous blister packages and sit down and push out the pills one by one. Turns out you really, really have to want to commit suicide to push out 50 pills. And most people are not that committed.
How do we know this would work? Because it already has:
In September 1998, Britain changed the packaging for paracetamol, the active ingredient in Tylenol, to require blister packs for packages of 16 pills when sold over the counter in places like convenience stores, and for packages of 32 pills in pharmacies. The result: a study by Oxford University researchers showed that over the subsequent 11 or so years, suicide deaths from Tylenol overdoses declined by 43 percent, and a similar decline was found in accidental deaths from medication poisonings. In addition, there was a 61 percent reduction in liver transplants attributed to Tylenol toxicities.
Of course, this idea horrifies right-wingers. Ann Althouse sneers:
But if we could save one life... the life of the insufficiently committed... suicidal but too lazy to poke enough pills out of the blister packs...

You know the type. For them, life is not worth the trouble. And then suddenly killing yourself is also a lot of trouble. What's more trouble? Living or these damned blister packs?
Conventional wisdom says that the suicidal will always find a way to kill themselves. It turns out that the conventional wisdom is wrong. Go read this New York Times Magazine story on suicide. The British switched from carbon-monoxide-producing coal gas to natural gas in the 1960s and 1970 and absolute suicide numbers declined by a third; a suicide barrier was erected on the Ellington Bridge in Washington, D.C., and suicides there declined, without any increase on the nearby Taft Bridge. And UC-Berkeley professor Richard Seiden learned that merely preventing a suicide once can be sufficient:
In the late 1970s, Seiden set out to test the notion of inevitability in jumping suicides. Obtaining a Police Department list of all would-be jumpers who were thwarted from leaping off the Golden Gate between 1937 and 1971 -- an astonishing 515 individuals in all -- he painstakingly culled death-certificate records to see how many had subsequently "completed." His report, "Where Are They Now?" remains a landmark in the study of suicide, for what he found was that just 6 percent of those pulled off the bridge went on to kill themselves. Even allowing for suicides that might have been mislabeled as accidents only raised the total to 10 percent.

"That's still a lot higher than the general population, of course," Seiden, 75, explained to me over lunch in a busy restaurant in downtown San Franciso. "But to me, the more significant fact is that 90 percent of them got past it. They were having an acute temporary crisis, they passed through it and, coming out the other side, they got on with their lives."
Wesley J. Smith of National Review is a appalled in a more traditionally right-wing way:
I believe in reasonable regulations to protect public safety, for example, requiring that an odor be put into natural gas and the wearing of seatbelts in cars....

Like I said, reasonable regulation is legitimate. But at what point does too much become too much?
Show of hands: Who believes that Wesley J. Smith -- or any National Review writer -- would be in favor of requiring seatbelt use in cars, or putting an odor in natural gas, if we weren't doing these things already! (The cost! The nanny-statism! Our precious freedom!)

Ezekiel Emanuel has worked in the Obama White House. His brother used to be Obama's chief of staff and is now the mayor of Chicago. His other brother is a big kahuna in evil liberal Hollyweird. We're never going to do anything like this precisely because a guy like Ezekiel Emanuel thinks it's a good idea.

If we want this to happen, liberals have to oppose it. We have to persuade the right that we think big bottles of Tylenol have to stay on the market because taking them off the market would discriminate against transsexuals of color with multiple disabilities. Also, that George Soros makes billions of dollars off Tylenol suicide.

Get them to believe that, and then we'll switch to blister packs.


UPDATE: Good point here.



Tom Hilton said...

I had no idea it was possible to kill oneself with Tylenol, much less that lots of people actually do it. Huh.

Superfluous Man said...

All my prescription meds from India come in blister packs. So why don't we just import all our drugs from India? They're much, much cheaper, too.

Ross said...

Seems like blister packs would be a pretty massive obstacle to folks who are taking painkillers for, say, crippling joint pain.

I know I've had days where if my tylenol was in a blister pack, I'd just go back to bed and cry for a few hours instead of fighting with the blister pack.