Are parents’ prescriptions poisoning kids?

Every parent knows how hard it can be to keep their prescription drugs safely away from their children. But with the increase in adult prescription drugs in the home, that problem is getting harder to manage. Today, more and more young kids are accidentally taking their parents’ pills, and more and more teens are intentionally raiding the medicine cabinet. This has led to rising rates of poisonings in children, according to a study

published in the July 2013 issue of Pediatrics. (Adult Prescription Drug Use and Pediatric Medication Exposures and Poisonings)

Two of the study’s authors, Lindsey C. Burghardt, MD, and Florence T. Bourgeois, MD, MPH, became interested in the subject based on their real-life experiences as pediatric emergency medicine doctors at Boston Children’s Hospital. Burghardt reports that they noticed what seemed to be an increase in children and adolescents coming to the emergency room who had been poisoned by prescription medications. “When we began to research the problem of pediatric medication poisonings, we learned that adult prescriptions are also increasing.  We began to wonder if these things were related.”

To find out, the researchers measured monthly pediatric exposures and poisonings using statistics in the National Poison Data System. They also looked at statistics on prescriptions written for adults compiled in the National Ambulatory Medical Care Surveys for the years 2000 through 2009. Their review of the data revealed a strong association between adult prescriptions and children being poisoned by those medications.

The study states that medication exposures and poisonings declined slightly in the 1990s, but the downward trend started to reverse in the last decade. For example, emergency room visits and actual hospitalizations for children from exposures and poisonings caused by medications jumped by 30% and 36%, respectively, between 2001 and 2008. At this same time, the study points out, adult prescription rates were on the rise.

The greatest risk of poisoning was among children up to age 5, followed by 13- to 19-year-olds

Digging deeper in the data, the authors looked at statistics on poisonings from diabetes drugs, statins and other lipid-lowering medications, as well as beta-blockers and pain-killers (opioids). “We chose these drugs because they are most widely prescribed among adults,” Bourgeois explains. They found that visits to the emergency room were most common for poisonings with diabetes medications and beta-blockers, while opioids and diabetes medications led to more serious injuries and hospitalizations.

Across all classes of drugs, the greatest risk of poisoning was among children up to age 5, followed by 13- to 19-year-olds.

“With increased prescriptions, there is greater availability of drugs everywhere,” Burghardt states, and greater availability of drugs means increased opportunities for children and teens to get those drugs, either accidentally or on purpose. Still, Bourgeois says, “we were surprised by the increasing number of poisonings especially in the context of all the work that has gone into preventing these kinds of poisonings.” Child-proof caps, warning labels and educational campaigns on safe medication storage, she states, have done much over the years to keep kids safe, but a serious and growing problem remains.

“Part of what’s interesting about the study,” Burghardt says, “is that this is a problem that affects kids of all ages.” Still, she points out, there are different reasons that different kids get their hands on their parents’ medications. “For children less than 5 years old, it’s purely exploratory,” she explains, but for teenagers, using prescription drugs could be “recreational or it could signal the potential for self-harm.”

For this reason, Bourgeois asserts that “we need more information about what the medications are and who’s being exposed to it.” Burghardt concurs, stating that “we need to look at ED admissions, psychiatric hospitalizations – it requires a different thought process.”

A different thought process and more data may lead to more effective strategies for reducing poisonings. “Can we define populations that are at greatest risk?” Bourgeois asks. “We need to know more about the types of drugs being prescribed, the characteristics of the adults using them, and who has access to them and under what circumstances.” This information, coupled with greater diligence and awareness on the part of parents and medical professionals, may help reverse the trends.

But for now, as prescription rates for adults continue to rise, the risks for children remain.