Figures show that each year half a million kids age 5 and younger get into household medications and are poisoned. Though parents tend to believe that these tragic accidents will never happen to their kids, Dr. Randall Bond, a leading advocate for better prescription drug safety in the home, believes it can happen to anyone.
According to research led by Bond and his colleagues at the Cincinnati Children's Hospital Medical Center, the number of kids under 5 seeking emergency medical care because of these poisonings increased by 28 percent between 2001 and 2008. “Ninety-five percent of these visits were related to kids getting into somebody's medicine, not due to mis-dosing of their own medicine and the vast majority were of prescription meds,” says Bond.
The researchers looked at visits to emergency departments, hospital admissions, injuries, and trends. They evaluated a total of 453,559 records. In 95% of cases, the child got into the medicine. Most problems occurred after children got into prescription medicines. Children getting into prescription medicines accounted for more than 248,000 emergency department visits, nearly 42,000 hospital admissions, and more than 18,000 injuries.
This may be due to the fact that more people are prescribed prescription painkillers than in the past, so these drugs are more present in the home, says Dr. Gary Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital. Prescriptions for the painkiller oxycodone, for example, have gone up more than 500 percent in recent years, he says.
Because kids spend most of their time at home, having more prescription drugs, especially potent ones like opiate painkillers, poses a great threat to toddlers and preschoolers, who tend to explore their surroundings, Smith adds. These drugs can have deadly consequences, much more so than over-the-counter meds, Bond says, “One 80 milligram oxycodone is enough to kill a child - he'll stop breathing.”
The rise in child poisonings by prescription drugs has led the Centers for Disease Control and Prevention to spearhead Project Initiative, a collaboration between the Food and Drug Administration, private sector companies and consumer/patient advocates, which meets next week to discuss medication safety and how to better design medication packaging to make it more childproof.
While the mantra for keeping household medications kidproof has always been to keep them “up and away and out of sight,” this doesn't always work around curious toddlers. “We need to build better 'mousetraps' so that adults can still get into the bottles but kids cannot. Parents also need to be more vigilant, especially when grandparents, who tend to have more medications, visit or the kids go to their grandparents,” Bond says. One option for parents is to lock away their medication, especially sedatives, cardiac medications and painkillers, which are most likely to be deadly when ingested by children, says Smith.
It's also important for parents to get rid of extra medications so that there are not numerous prescription drugs hanging around the house, says Dr. William Shrank, a professor of medicine at Harvard University. “There's growing evidence that more and more teens are getting hooked on the prescription drugs that they can get in their own medicine cabinet or those of family members, and this study further highlights how keeping these unused medication around can be dangerous for younger kids as well,” he says.
Millions of pounds of prescription medications go unused every year in the U.S., according to the American Society of Consultant Pharmacists. While most people leave these extra pill bottles in the back of the medicine cabinet, they should be bringing back unused pills to their doctors, to pharmacists or to established Prescription Drug Take-Back days sponsored biannually by the U.S. Drug Enforcement Agency. Pills should not be flushed, as is often depicted in movies, because they can contaminate the water supply.
The study is published in The Journal of Pediatrics.
Dr. David Juurlink, a medical toxicologist at Sunnybrook Health Sciences Centre in Toronto, said there is no agency in Canada that keeps track of national medication poisonings among children, but there's no reason to think the upward trend differs from the U.S. experience.
Pam Fuselli, executive director of Safe Kids Canada, agreed, adding that visitors who may have medications in a bag or purse should not leave them on the floor and should make sure they are zipped tight. Young children like to explore, it's part of their development, she said. “That's how kids learn, and they put things in their mouths, especially the younger ones. I think that a lot of people figured that once the child-resistant caps had come out, 'We've done with poisoning, we've addressed that issue.' It's obvious that there's more still to be done.”
Juurlink said pharmaceutical companies should also avoid making their products attractive to young children who have the dexterity to put pills in their mouths while not understanding their potential danger. “There are some drugs that actually look like candy,” he said. “A notorious one are the iron products ... they're typically little reddish or greenish tablets that don't look a whole lot different really than Smarties or M&M's.”
Some adult medications, among them a potent blood pressure and heart drug called verapamil, are sugar-coated. “This is one of the most dangerous pharmaceuticals out there, it's very commonly used,” Juurlink said. “There is no reason to cover a pill with sugar, especially when it's a pill that one or two tablets could kill a child. So the message for industry is stop making pills that look or taste like candy.”
Next, Bond says, the project will start discussions with pharmaceutical companies about how to help reduce poisonings. Strategies include, for instance, adding a “'flow dispenser”' to liquid medicines. That way, children can't take off the top and drink it all.
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