Saturday, September 17, 2011

Drug Poisoning in Children on the Rise

A recent study published in the Journal of Pediatrics blames greater availability of prescription medications in the household for a rise of accidental drug poisonings in children. The large majority of these accidents which lead to serious poisonings, hospitalizations and even death are from young children finding and ingesting drugs by themselves. Failure to poison-proof a household may play a role. The larger problem is simply the increased use and availability of prescription medications including pain medications, narcotics, sedatives for sleep, muscle relaxants for injury and cardiovascular prescriptions. Dosing mistakes for pediatric patients account for only a very small portion of the problem. Past emphasis by FDA and other professionals has minimized therapeutic mistakes and does not account for the rise of serious drug poisoning in children. The offending medications are often not even drugs that are commonly used for children.

The most recent surveys show that 55% of adults have taken a prescription medication within the last week and 11% have taken five or more prescription drugs within the preceding week. The use of over-the-counter medications such as common anti-inflammatory products and acetaminophen has increased and created more prevalence in the home. However the largest increase in poisonings remains from prescription medications. Therefore there are more adult medications around that are toxic to toddlers and young children. Medications of seniors or grandparents were estimated to be involved in these accidents only 10 to 20% of the time. These products are often stored in containers or pill reminders that are not child resistant. The rise of more serious admissions for accidental poisonings and the types of drugs ingested, point to the greater availability of medications in the child’s environment, without adequate precautions for protected access.  

Some experts believe there are limitations to education about prevention and poison-proofing the home for toddlers and young children. The consensus among experts in behavior is that the best efforts in childproofing will result in prevention 90% of the time. Even that would be improvement over the status quo. The typical pattern for accidental ingestion is during the period of time that the medications are in use by an adult. They are probably left out for convenience without recognizing the hazard they present to a curious young child. Medication in locked cabinets is generally considered inconvenient which limits the accessibility especially when needed two or three times a day. The recent information sheds light on the prevalence of prescription medications in a household and the serious risks of self ingestion by children. Some experts have suggested new types of packaging that would restrict the access to medication by limiting the amount. This means flow restrictors for liquid medications and containers that would dispense only one tablet at a time. Such changes would have to be applied to both adult and pediatric products to have any beneficial effect.

Renewed education for all consumers about where the risks are that may be overlooked is an important first step. More thoughtful storage and access to prescription medications is necessary to restrict access to young children. In general the situation gives one reason to pause and consider society’s overall increased use of powerful medications such as opiates and sedatives which have clearly been on the rise. In turn, it has indirectly increased the risks to our children. Preventive measures need to take steps to decrease the immediate risks while evaluating the larger picture of a society that emphasizes appropriate use of therapeutic prescription drugs.

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