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The objective of this paper is to determine patients awareness of the toxicity of the drugs they overdose with, the source of these drugs, and whether they would have taken them had they been fully aware of their toxicity, and to examine the implications for prevention. A prospective review of one hundred consecutive overdoses admitted through an A&E department was carried out. Awareness was scored by a ranking questionnaire and intent by response to a standard question when toxicity was explained. Paracetamol was most the most frequently taken drug (39 cases). Overall awareness of toxicity was low. Twenty-eight patients (30%) said they would not have overdosed if they had been aware of the toxicity of what they had taken. Forty-nine per cent of patients took someone elses tablets. There is a rise in analgesic poisoning from 1976. Higher toxicity awareness may reduce the incidence of drug overdose. Smaller prescriptions and over the counter preparations especially paracetamol and limited access to toxic drugs, especially in high-risk homes, should reduce both the number and severity of overdoses. It is possible that a number of deaths from deliberate drug overdose may be unintentional as 30% of survivors in this study did not intend the toxic effects of the drug taken.