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Medicines Top Source of Kids' Poisonings
Date:8/4/2009

Over 70,000 children per year take painkillers, other drugs and end up in the ER, CDC says

TUESDAY, Aug. 4 (HealthDay News) -- The leading cause of accidental poisonings among American children can be found in the family medicine cabinet, a new government report shows.

Each year in the United States, more than 71,000 children aged 18 and younger are seen in emergency rooms for unintentional overdoses of prescription and over-the-counter drugs, the researchers found.

In fact, more than two-thirds of emergency department visits are due to poisoning from prescription and over-the-counter medications -- that's more than double the rate of childhood poisonings caused by household cleaning products, plants and the like, the team from the U.S. Centers for Disease Control and Prevention said.

"Medication overdoses are most common among 2-year-olds," added lead researcher Dr. Daniel Budnitz, director of the CDC's Medication Safety Program in the division of health-care quality promotion. "About one out of every 180 2-year-olds visits an emergency department for a medication overdose each year."

Dr. Robert Geller, a professor of pediatrics at Emory University School of Medicine and medical director of the Georgia Poison Center, said that "the number children seen in the emergency room due to overdoses that are unintentional or medication errors is remarkable."

Geller noted that many more people reach out to poison control centers for help than show up at the hospital. "Right now, poison centers are having their funding cut," he noted. "If poison centers are less available, the number of children going to emergency rooms will rise."

More than 80 percent of these overdoses are due to unsupervised ingestion, Budnitz noted. "Basically, it's young children finding and eating medicine without adult supervision," he said. "They are found with an empty bottle or pills in their mouth or something, and they are taken to the emergency department."

In addition, medication errors by caregivers or adults and misuse of drugs by preteens and teens cause about 14 percent of accidental poisonings, Budnitz said. "Basically, that's not following directions," he said.

The report appears online Aug. 4 in advance of publication in the September print edition of the American Journal of Preventive Medicine.

For the study, Budnitz's team used 2004 and 2005 data from the National Electronic Injury Surveillance System to estimate the number of emergency department visits resulting from unintentional medication overdoses for children aged 18 and younger.

The most common medications accidentally taken by children are acetaminophen, opioids or benzodiazepines, cough and cold medicines, nonsteroidal anti-inflammatory drugs (NSAIDs) and antidepressants, Budnitz said.

To help reduce the number of incidents of unintentional poisonings, especially in younger children, Budnitz believes drug manufacturers must create better child safety caps, including caps that limit the dose that can be dispensed.

Currently, the CDC is working with over-the-counter drug manufacturers to encourage the implementation of new "passive" safety caps, Budnitz said. These caps do not require that the user to do anything but close it to work, or they allow only a measured dose to be dispensed at one time.

There is a need to improve packaging to cut the number of cases of unintended ingestion, Geller said. "If you could make it harder for a kid who came upon a package to get the contents of the package, it would make it more likely they would never need to go to the emergency room," he noted.

Of course, there are things that can be done right now by parents and caregivers, Budnitz said. These include making sure the cap is tightly secured after taking medication and placing the bottle well out of the reach of toddlers.

While many overdoses are accidental, the dangers of opioid use among teens is the subject of a new study in this month's Archives of Pediatrics & Adolescent Medicine. That study, from University of Michigan researchers, found that pain relief is not the main reason that one in 10 high school seniors have tried opioid drugs. The most common reasons included relaxation, feeling good or getting high, experimentation and then pain relief. Students used drugs such as hydrocodone, oxycodone (Oxycontin), hydromorphone, meperidine, morphine and codeine without a prescription, the researchers found.

The dangers of misused cold medications for infants and young children has also been a topic of recent debate among experts. Following concerns raised by the U.S. Food and Drug Administration, leading drug makers in October voluntarily withdrew oral cough and cold medicines marketed for use in infants.

The move affects only "infant" oral medicines, not those intended and labeled for use in children aged 2 and older. And it comes as U.S. regulators review the products' safety, following reports of dozens of deaths since 1969.

"The reason the makers of over-the-counter oral cough and cold medicines for infants are voluntarily withdrawing these medicines is that there have been rare patterns of misuse leading to overdose recently identified, particularly in infants, and safety is our top priority," Linda A. Suydam, president of the Consumer Healthcare Products Association, said in a statement at the time.

More information

For tips to prevent drug poisonings, visit the U.S. Centers for Disease Control and Prevention.



SOURCES: Daniel Budnitz, M.D., M.P.H., director, Medication Safety Program, Division of Healthcare Quality Promotion, U.S. Centers for Disease Control and Prevention, Atlanta; Robert Geller, M.D., professor, pediatrics, Emory University School of Medicine, medical director, Georgia Poison Center, and chief, Emory Pediatric Staff, Grady Health System; Aug. 4, 2009, American Journal of Preventive Medicine, online


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