Image: JoNel Aleccia
By JoNel Aleccia Health writer
msnbc.com
updated 7/22/2010 8:46:16 AM ET 2010-07-22T12:46:16

Parents and caregivers who slip young, healthy children doses of common drugs — including painkillers, sedatives and laxatives — are fueling a dangerous but hidden form of child abuse, new research finds.

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About 160 kids are hurt in the United States each year — and at least two die — after being forced to ingest antidepressants, cough and cold medicines, even drugs to treat high blood pressure. Many are given alcohol, marijuana or cocaine, according to the first large-scale study of the issue published in the Journal of Pediatrics.

“We believe that the malicious use of pharmaceuticals may be an under-recognized form and or component of child maltreatment,” said Dr. Shan Yin, who led the study conducted at the Rocky Mountain Poison and Drug Center in Denver.

Yin, a medical toxicologist, analyzed more than 21.4 million calls to the National Poison Data System between 2000 and 2008. When he looked at cases of drug and alcohol poisoning coded as “malicious” in children younger than 7, Shin found 1,439 cases of kids who’d been exposed. Some 172 children were seriously injured and 18 died.

They included a 4-month-old girl killed in 2003 when a babysitter gave her a full bottle of decongestant, and a 5-year-old girl who died in 2006 after her mother gave her antidepressants and muscle relaxants.

“I just don’t know what goes on in the minds of people who try to harm their child,” said Yin, an emergency room doctor who has treated cases of abuse.

Parents may be angry, frustrated
Poison center records don’t include motives for the poisonings, said Yin. But he speculates that known causes for child abuse — punishment, frustration with the demands of parenting — may play a role in drug-induced harm.

“There’s a very wide spectrum, from frank homicides to people who are not trying to hurt their children,” he said. “Maybe they want them to go to sleep for an hour so they can go to sleep or go shopping.”

In some cases, an adult’s warped sense of amusement at seeing a child intoxicated could be the motivation.

“I think somebody might think it’s funny,” Yin said.

Sedatives were used in more than half the cases Yin studied, often in combination with other drugs. Pain relievers were found in 176 kids; laxatives were used in 67. The average age of the victims was 2, which is consistent with other types of child abuse.

While the number of documented malicious drug-abuse cases was small, Yin says his research is likely just a snapshot of a much larger problem. Abuse via malicious drug or alcohol abuse is not captured by current definitions of child maltreatment, which include physical, sexual and emotional use and neglect.  

When it does occur, not all cases are reported to the nation’s poison centers, Yin said.

Image: William Cunningham
Clayton County Police Department
This undated photo released by the Clayton County Police Department shows William Allen Cunningham, who has been sentenced to 100 years in prison for poisoning his two children. Prosecutors said Cunningham laced his children's soup with prescription drugs and lighter fluid in a scheme to extort money from Campbell's Soup Co. in 2006. The children, then ages 18 months and 3-years, were sickened but survived.
For instance, the poison center data didn’t include the case of William Allen Cunningham, a Georgia man who in 2006 poisoned his 3-year-old son and 18-month-old daughter by feeding them canned soup laced with hot peppers and lighter fluid and later with prescription antidepressants. Cunningham then tried to extort money from the Campbell Soup Co. by claiming the soup was tainted when he bought it.

He was sentenced to 100 years in prison last year, according to news reports.

Links to physical abuse
Poisoning likely is occurring in conjunction with other kinds of child abuse, including the nearly 150,000 cases of physical abuse reported each year, Yin said. He’d like to see comprehensive drug screening for children who show up in emergency departments with suspicious injuries.

Child abuse caused by poisoning is a rare but recognized harm, said Jim Hmurovich, president and chief executive of Prevent Child Abuse America, an advocacy agency. While he had yet to review the new study, Hmurovich said it points to the need for better child abuse prevention efforts.

“I don’t think it’s right at any time to give unprescribed medicine to a child,” he said. “Did the parent do it out of frustration? Did they do it at their wits’ end? If that’s the case, we need to be even more aggressive in terms of parent education.”

Yin said he hopes his study makes people think twice about using drugs to calm children.

“For parents, there’s a spectrum. I personally know friends who have given children Benadryl on a plane,” he said. “But any time you give a child a non-prescribed medication, you run the risk of harming the child.”

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