More Accidental Drug Poisonings of Children

The growing use of prescription drugs by adults, from pain relievers to sleep aids and heart medications, has led to an increase in accidental drug poisonings of children, new research shows.

Despite childproof caps and safety warnings, the number of accidental drug poisonings among young children surged 22 percent from 2001 to 2008, according to a new study in The Journal of Pediatrics. The reason, say researchers, is that prescription drug use by both adults and children is on the rise, and there are simply more bottles of pills in the home that can potentially be accessed by curious children.

Researchers from Cincinnati Children’s Hospital Medical Center and the University of Cincinnati analyzed national poison control center data on 544,133 children ages 5 and younger who had visited an emergency department between 2001 and 2008 after an accidental medication poisoning.

In 95 percent of the cases, the poisoning occurred because the child ingested the drug, as opposed to a labeling or dosage error by a parent or health care worker. Prescription drugs were a bigger problem than over-the-counter drugs. Prescription drugs accounted for 55 percent of the drug-poisoning visits to the emergency room, but represented nearly three quarters of serious injuries. In fact, 43 percent of the children admitted to the hospital after accidentally ingesting a prescription drug ended up in intensive care.

The biggest culprits were opioid drugs for pain relief, like oxycodone and codeine; sedatives, like muscle relaxers and sleep aids; and prescription heart drugs.

The sheer ubiquity of prescription drugs in the home is most likely contributing to the increase in accidental poisonings, said the study authors.

“It is also possible that some types of medications previously less available in the environment of young children have become more available,” the authors wrote. “As obesity and the metabolic syndrome have increased in prevalence and affected younger adults, more homes of small children may have antihypertensive and antidiabetic medicines prescribed for parents or siblings.”

Changes in drug technology may also be contributing to the increase. For instance, the increase in sustained-release medications may be contributing to more severe poisonings. Shifts in prescribing practices may also be leading to more toxic drugs in the home. For instance, heart patients who in the past took diuretics for blood pressure are now prescribed beta blockers and calcium channel antagonists, which can lead to more toxic overdoses.

Parents may also be becoming less vigilant about poisonproofing homes by storing drugs in locked cabinets.

“All medication users find it inconvenient to store medication in locked cabinets, particularly medications that are used once or several times daily,” the authors wrote. “They may not understand the life-threatening impact of some medications in just one dose, discount the potential toxicity of O.T.C. medications, or underestimate the likelihood that it will happen in their home with their children.”

The authors said the best solution would be to design new packages for both adult and pediatric drugs that would not only be difficult to open but also make it more difficult for a young child to ingest large quantities. For instance, liquid medication bottles can be designed to restrict flow. Pill bottles can be made to dispense only one tablet at a time.