Pediatric Poisonings Increase Along With Adult Prescriptions

As the number of medications prescribed to adults has increased, so has the number of children exposed to and poisoned by prescription medications, indicating a need for better counseling and improved drug packaging.

More children are being exposed to prescription drugs unintentionally due to an increase in the number of drugs prescribed to adults, according to results of a study published in the July 2013 issue of Pediatrics. Although public interventions regarding safe medicine storage have reduced the number of overall deaths caused by medication poisonings in children, the number of children visiting emergency rooms as a result of medication ingestion is increasing.

The researchers collected data on monthly pediatric poisonings from the American Association of Poison Control Centers’ National Poison Data System (NPDS). Exposures to the medications most commonly prescribed to adults were analyzed, including opioids, antihyperlipidemics, antidiabetic agents, and beta-blockers. All NPDS reports from 2000 through 2009 were included, unless the poisoning was related to a pediatric prescription dosing error. Reports were analyzed for medications ingested, number of emergency department visits, number of hospitalizations, and clinical effects in 3 age groups: 0 to 5 years old, 6 to 12 years old, and 13 to 19 years old.

Data on prescriptions given to adults aged 20 years and older from 2000 to 2009 for the drugs in question were collected and analyzed using the National Ambulatory Medical Care Survey. The average monthly number of pediatric poisonings related to the 4 drug classes was calculated for each age group as well as the average number of adult prescriptions for these drug classes. Using multiple time-series analysis, the researchers then evaluated connections between adult prescriptions and childhood poisonings.

The results showed a significant association between adult prescriptions and medication poisonings in children of all age groups. The association was approximately 2 times stronger for opioids compared with the other drug classes. For every 1% increase in the number of adults prescribed opioids, researchers observed an increase of 1.53 in the number of exposures and poisonings per million children aged 0 to 5, an increase of 0.08 in the number of exposures and poisonings per million children aged 6 to 12, and an increase of 0.74 in the number of exposures and poisonings per million children aged 13 to 19 years old. Children aged 0 to 5 years were determined to be at the greatest risk and also had the highest average number of total poisonings among the 3 age groups.

The authors conclude that their findings may indicate that increased adult prescriptions are directly causing the increase in medication poisonings among children. They note that medication safety interventions should take into account the quantity of adult prescriptions available to children and that pediatricians and physicians should consult parents when prescribing new medications. The authors also suggest that packaging for certain drugs may need to be modified to help reduce the problem.