June 3, 2013 at 1:36 AM ET
They’d treated a teenager who overdosed on antidepressants, and a toddler whose blood sugar plunged after she picked up some diabetes pills on the floor of her aunt’s house. And Dr. Lindsey Burghardt and Dr. Florence Bourgeois had seen the reports noting that more and more kids were being poisoned by prescription drugs meant for adults.
Other groups had speculated that the rise in poisoning was linked to a big increase in adult prescriptions. Now Burghardt, Bourgeois and colleagues have solidly confirmed the connection – the increase in poisonings correlates directly with the increase in prescriptions being filled.
As Americans get older, heavier and more out of shape, they’re being prescribed more and more medications to lower their blood sugar, cholesterol, blood pressure – and to treat pain. And new formulations mean medications stay in the body longer.
“We felt like we were seeing so many children with poisonings related to prescription drugs,” says Burghardt, an emergency room doctor at Boston Children’s Hospital. Other studies had shown a 36 percent increase between 2001 and 2008 in the number of kids hospitalized after taking prescription drugs meant for someone else.
The team used statistics from the National Poison Data System, and compared them to data on prescriptions written for adults using the National Ambulatory Medical Care Surveys for 2000 through 2009.
“Increasing rates of adult drug prescriptions are strongly associated with increases in drug exposures and poisonings among children and appear to be a direct cause of exposures and poisonings,” they wrote in a report published in the journal Pediatrics.
Over that time, 38,485 children took diabetes drugs that lower blood sugar; 39,693 took cholesterol-lowering medications; 49,075 took blood pressure drugs called beta-blockers, which slow heart rate, and 62,416 took opioid painkillers. Kids 5 and younger were by far the most likely to be poisoned, but 2,330 teens were treated for opioid poisoning, and they very likely took the drugs on purpose, Burghardt says.
Burghardt’s team only looked at those four drug classes, as they were the most commonly involved in poisonings.
Opioids kill quickly, but drugs for diabetes can lower blood sugar dangerously, blood pressure medications can slow or stop the heart, and any drug overdose can cause irreversible liver or kidney damage. Antidepressants can cause deadly heart rhythm disturbances, and even over the counter painkillers like Tylenol can damage the liver - sometimes causing a painful and lingering death.
The data fits in with a study done in 2011 by a team at Cincinnati Children’s Hospital who found prescription drugs accounted for 55 percent of kids 5 and younger treated in emergency rooms for medication poisoning, and that 43 percent of the children required intensive care.
The US. Centers for Disease Control and Prevention, reports a 160 percent rise in unintentional poisonings from 1999 to 2009, 91 percent of them the result of a drug overdose.
Burghardt treated a 3-year-old who grabbed a handful of her grandmother’s diabetes and heart drugs. “The grandmother stored her medications in one of those weekly medication dispensers, the kind with the days of the week on them,” Burghardt said.
The curious child grabbed a few and popped them in her mouth. She was fine, but had to be admitted to the hospital to make sure the diabetes and blood-pressure-lowering drugs didn’t send her into a fatal coma.
Child-resistant packaging just isn’t enough to protect kids, the researchers noted. Adults often don’t replace the lids on prescription bottles – and kids older than 5 can get those lids off, anyway. And no resistant packaging is going to deter a teenager bent on experimenting with a painkiller or, worse, determined to take a deliberate overdose.
The first line of defense is the pediatrician, says Bourgeois, who works alongside Burghardt. They need to counsel parents about the dangers – which aren’t just in their own homes. “It could be the grandparents’ home, or the home of any adult,” she said.
Blister packs can help, so kids can’t just grab a handful of pills from a bottle. Really dangerous drugs such as opioids can be dispensed in individual blister packs to reduce the risk of accidental poisoning or abuse. It might even be necessary in some cases to require patients to fill opioids on a pill-by-pill basis, Bourgeois says.
“Physicians prescribing drugs to adults should also be aware of the potential risk of exposures to children and provide guidance accordingly,” the research team added.
And for parents of teens at risk of taking drugs on purpose, it might be necessary to completely remove them from the home, Bourgeois says.
Everyone needs to know the number of a poison control center, to get immediate guidance if they even suspect a child has taken a prescription drug. The nationwide toll-free number for the American Association of Poison Control Centers is 1-800-222-1222.