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This article was previously published on February 26, 2020 and has been updated with new information.
In addition to causing a number of side effects in those taking the medication, widespread routine use of the medication also poses a serious risk to children who get their hands on it.
As of 2016, nearly half of the U.S. population has been taking at least one drug.1,2 Twenty-four percent used three or more medications, and 12.6% took more than five different medications.3 According to the 2016 National Outpatient Care Survey, 73.9% of all physician visits included drug therapy.4
As expected, drug use increases dramatically with age. As of 2016, 18% of children under the age of 12 have been taking prescription drugs, compared to 85% of adults over the age of 60. While this trend is worrying enough, with prescription drugs now the mainstay in most homes, the number of children suffering is on the rise as well as accidental poisonings.
Medications pose serious risks to young children
In September 2021, US News and World Report reported that child poisoning increased dramatically during the pandemic.5 For example, the Children’s Hospital of Philadelphia doubled in number only in the second half of 2020. The reason, health officials say, is that more and more people working from home have become distracted or forgetful with medications than usual.
Unfortunately, child poisoning has been on the rise for several years. According to an article from 20126,7 in The Journal of Pediatrics, which reviewed patient records from the National Poison Control System of the American Association for Poison Control Centers, 453,559 children aged 5 or younger were admitted to a health facility after exposure to a potentially toxic dose of a pharmaceutical drug between 2001 and 2008. .
At that time, drug poisonings increased by 22%. Ninety-five percent of the cases were due to self-exposure, which means that the children went into the medicine and took it themselves, as opposed to giving them an overdose by mistake.
Forty-three percent of all children admitted to the hospital after accidentally swallowing medication ended up in the intensive care unit, and prescription drugs (as opposed to over-the-counter ones) were responsible for 71% of severe injuries, with opioids, sedative-hypnotics, and cardiovascular drugs top the list of drugs that cause serious harm. As the authors noted:8
“Prevention efforts have proved inadequate given the growing availability of prescription drugs, especially dangerous drugs.”
Keep all medicines in children’s containers
If you are older, you may remember that your parents or grandparents would have a lockable medicine cabinet in which the medicine was stored. Few people these days keep their medications in locked lockers or boxes, not realizing the serious risk they pose to young children.
The danger is further increased if you classify your medicines into easily open daily pill organizers instead of keeping each medicine in the original children’s container.
Work from 20209,10 in The Journal of Pediatrics, which sought to “identify the types of containers from which young children accessed solid doses of drugs during uncontrolled drug exposure,” found that 51.5% included drugs accessed as a result of removal from the original child-resistant packaging .
Interestingly, in 49.3% of cases involving drugs for attention and hyperactivity disorder and 42.6% of cases involving opioids, the drug was not in any container at all when it was approached. In other words, the child found a pill or pill that was just lying in the open. In 30.7% of all cases in which the child ingested drugs, the exposure included grandparents ’medications. As the authors noted:
“Efforts to reduce pediatric SDM [solid dose medication] exposures should also refer to exposures in which adults, not children, remove medicines from child-resistant packaging.
Packaging / storage innovations designed to encourage adults to keep products in child-resistant packaging, and specific educational messages can be targeted based on the usual circumstances of exposure, the classes of drugs and the recipients of the drugs that are intended. “
Drug overdoses among teenagers are also on the rise
While infants are known to put anything and everything in their mouths, making them particularly vulnerable to accidental drug exposure, drug overdoses, especially those involving opioids and benzodiazepines, are also becoming more common among teenagers who have access to these drugs.
According to a study from 201911 published in the journal Clinical Toxicology, 296,838 children under the age of 18 were exposed to benzodiazepines between January 2000 and December 2015. During that time, benzodiazepine exposure in this age group increased by 54%. According to the authors:12
“The severity of medical outcomes has also increased, as has the prevalence of concomitant use of multiple drugs, especially in children aged 12 to <18. Almost half of all reported exposures in 2015 were documented as intentional abuse, abuse or suicide attempt, reflecting a change in compared to previous years…
Healthcare professionals and carers should be aware of this growing epidemic to avoid possible harm to adolescents, young children and infants. “
A similar trend was found with opioids. 2017 study13 looking at prescription opioid exposure among children and adolescents in the U.S. between 2000 and 2015, we found:
“Poison Control Centers received reports of 188,468 prescription opioid exposure among children under the age of 20 from 2000 to 2015. … Hydrocodone accounted for the largest share of exposure (28.7%) and 47.1% of children exposed to buprenorphine it was an ad facility (HCF).
The chances of admission to HCF were higher for teenagers than for children aged 0 to 5 or children aged 6 to 12. Teenagers were also more likely to have serious medical outcomes… The rate of suspected prescription opioid-related suicides among teens increased by 52.7% during the study period. “
Common sense precautions
The U.S. Centers for Disease Control and Prevention promotes and supports the Up and Away and Out of Sight campaign, which focuses on “a few simple data-based actions that parents and caregivers can take to prevent drug overdoses in children being cared for and cared for. take care of. “14 These common sense precautions include the following:15
- Store your medicines (and supplements) in their original packaging in a place that your child cannot reach. Don’t store medications in your nightstand, purse, or coffee table where little hands are likely to research and find them. All medicines stored in the refrigerator should be in child-resistant packaging. Also make sure the drugs are safely stored in areas that your child visits frequently, such as grandparents or nannies.
- Dispose of all medications after each use.
- Be sure to lock the safety cover again after each use.
- Teach your children about drug safety; never tell them the drug is “like candy” to get them to take it.
- Remind guests to place bags, purses and coats containing medicines in a safe place during the visit.
What to do in case of accidental drug exposure
Be sure to keep the poison aid number in your phone and check with your nanny or caregiver. In the US, the poison aid number is 800-222-1222. If you suspect that your child has taken prescription or OTC medications, even if he or she is not yet showing symptoms, call the poison helpline immediately.
If you are not sure what medications your child may have taken, call 911 or the emergency number in your area for transportation to the nearest medical facility. While your baby may look good in the first few minutes, that can change quickly. You want to start treatment as soon as possible to reduce the risk of permanent damage or potential death.
Remember to bring with you the names of any medications your child may have accidentally swallowed, as well as any medications your child has taken in the last 24 hours as prescribed by their doctor, any allergies they have, and any changes or symptoms you may have observed.
Unfortunately, the symptoms of drug overdose can vary greatly, depending on the medication, the dose, and the age of the child. However, symptoms of an overdose may include:16
|
Nausea |
Vomiting or diarrhea |
|
Saliva or dry mouth |
Convulsions |
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Pupils growing or shrinking |
Sweating |
|
Loss of coordination and / or slurred speech |
Extreme fatigue |
|
Yellow skin or eyes |
Flu-like symptoms |
|
Unusual bleeding or bruising |
Abdominal pain |
|
Stiffness |
Accelerated heart rate |
If your child shows any of the following symptoms, call 911 (US) immediately:17
|
He won’t wake up |
I can not breathe |
|
He twitches or shakes uncontrollably |
It shows extremely strange behavior |
|
He has trouble swallowing |
They develop a rash that spreads rapidly |
|
It swells on the face, including around the lips and tongue |
The opiate epidemic is taking its toll on the pediatric population
It is crucial to understand that many drugs can be life-threatening for a young child, even in small doses. This is especially true of opioids and buprenorphine, a drug used to treat opioid addiction. As stated in the 2005 paper18 on opioid exposure in young children:
“Swallowing opioid analgesics by children can lead to significant toxicity as a result of depression of the respiratory and central nervous systems. A review of the medical literature was conducted to determine whether low doses of opioids are dangerous in the pediatric population under 6 years of age.
Methadone has been found to be the most toxic of the opioids; doses of just one tablet can lead to death. All children who have ingested any amount of methadone must be observed in the Emergency Room (ED) for at least 6 hours and be considered for hospitalization.
Most other opioids are better tolerated by swallowing just one or two tablets. Based on the limited data available for these opioids, we conclude that equianalgic doses of 5 mg / kg of codeine or more require 4 to 6 hours of observation in ED.
Data for propoxyphene and all sustained release formulations are limited; their extended half-life would indicate the need for longer observation periods. Any ingestion of opioids that leads to respiratory depression or significant central nervous system depression requires admission to an intensive care unit. “
Similarly, the 2006 paper19 on the adverse effects of unintentional exposure to buprenorphine in children noted that:
“Buprenorphine in sublingual formulation was recently introduced to the U.S. market for the treatment of opioid dependence. We report a series of 5 infants with respiratory and mental depression following unintentional exposure to buprenorphine.
Despite the partial agonistic action of buprenorphine and the maximum effect on respiratory depression, all children required hospital admission and opioid antagonist therapy or mechanical ventilation …
The growing use of buprenorphine as a home therapy for opioid dependence in the United States raises public health concerns for the pediatric population. “
The message you can take home is that as drug treatment increases and becomes more prevalent among all age groups, so does the risk of unintentional exposure. Young children will stick almost everything in their mouths, and young children will often not recognize the difference between pills and sweets.
As parents and caregivers, we simply need to take the necessary precautions to keep all medications in a safe place, out of the reach of curious hands. Failure to protect your medications can have deeply tragic consequences, so please don’t take this matter lightly.
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