Important components of suicide prevention are set out in NICE’s key therapeutic topic 24 (KTT24), ‘Suicide prevention: Optimising medicines and reducing access to means of suicide’, which may include restricting availability of medicines for purchase, on prescription and in the home. Strategies include prescribing only short-term supplies (e.g. weekly prescriptions). The following list contains other practical actions that could be included in a pharmacy action plan:

• Reminders and reinforcement of limits on OTC analgesics with pharmacy teams
• Closer monitoring where a patient is prescribed more than one medicine known to be commonly used in self-poisoning attempts (e.g. enquiring about opioid-containing analgesics kept at home)
• Reducing stockpiling and actively encouraging the return of unwanted medicines to the pharmacy
• Referring patients for a medication review in line with the NICE guideline on medicines optimisation.

During the pandemic, some GP surgeries temporarily increased the amount of medication supplied on prescriptions to help manage workload so some patients will have more medicines in the home and the risk of overdose may be increased. 

Being able to respond in an acute situation when a pharmacy patient or customer displays or discloses signs of being at risk is key. The Zero Suicide Alliance (ZSA) identifies three steps: see, say and signpost.