Dr. Scott McFarland laments what he calls “a sheer numbers game” — the number of prescription drugs taken by adults in any given household has soared in the last decade, and with it the rates of children and teens poisoned by those medications.
Mix in over-the-counter meds, and the count reaches 70,000 children a year treated in the nation’s emergency rooms for poisoning — a leap of about one-third since 2001.
In the first six months of 2013, Florida poison control fielded 493 calls regarding children with exposure to just four different classes of adult prescription medicines.
Child-resistant packaging and out-of-reach medicine cabinets have given parents a false sense of security, said McFarland, the chief of Palm Beach Gardens Medical Center’s emergency room.
Experts around the country agree.
Nearly half the children poisoned by medications find the drugs on the ground or in someone’s purse, bag or luggage, according to the Washington-based organization Safe Kids Worldwide.
The last victim McFarland recalls was a toddler who got into his grandfather’s heart medicine.
“They were sure they saw the child pick up a pill off the floor. The child’s heartbeat was slow,” said McFarland. The wait for the child’s recovery was even slower and emotionally fraught.
“Granddad feels horrible and you can’t say, ‘Everything’s going to be all right,’ because you don’t know,” McFarland said. The boy survived, but not all do.
This month, research published in the medical journal Pediatrics confirmed what had only been suspected: The number of prescriptions written to adults nationally has a direct correlation to the number of children and teens sickened by them.
The authors tracked from 2000 to 2009 the prescribed use of diabetes drugs, cholesterol fighters, beta-blockers and pain-killing opioids and compared them to pediatric emergency room visits.
A 1 percent increase in reported prescriptions in any given month was followed by larger increases in child exposures and poisonings in the following month — a pattern most evident in children 5 years old and younger, according to the researchers.
The drugs that were most likely to result in serious injury or hospitalization?
The diabetes sugar-lowering hypoglycemics and the pain-killing opioids that include oxycodone, researchers concluded.
“I’m a pediatric-emergency doctor and I felt like I was seeing more and more of these children come in,” said Dr. Lindsey Burghardt, based at Boston Children’s Hospital and the lead author of the Pediatrics study.
“This is helpful as it begins to explain the problem,” Burghardt said. “Great things have been done. Precautions have been put in to place to prevent these poisonings, but the problem persists. In fact the number of poisonings has been increasing.”
The biggest dent in child poisonings came in 1970 when the government began requiring medicine to be packaged in child-resistant containers.
The change was estimated to have cut in half the annual death rate among children ages 5 and under.
But child-resistant is not child-proof. And those colorful pills don’t always stay in their prescribed bottles.
“It can be that little pill container box that’s left in a nightstand or purse. It just takes a second,” said Kate Carr, Safe Kids Worldwide’s president and chief executive officer.
Carr knows from personal experience. Years ago, her oldest, then 2, swallowed most of grandmother’s blood-pressure medicine left on a table as grandma and uncle were handing off babysitting duties.
“My daughter survived — she’s now 32 — but that moment, it was a panic-stricken moment that I can vividly recall,” said Carr, who retells the 911 call and then the call to the poison center.
The Pediatrics study indicates the toddler set is most vulnerable to poisoning, a conclusion that doesn’t surprise Dr. Tommy Schectman, a Palm Beach Gardens pediatrician.
They live to put anything into their mouths, particularly something that looks just like candy, he said.
Calls to Florida’s poison control centers mirror the study’s findings.
For example, from 2000 to 2009 there was a 14 percent increase in calls to the state’s poison hotlines regarding children under age 5 and hypoglycemic medicines that treat diabetes — a disease and thus a class of medicine on the rise.
In 2012, Florida poison control fielded 140 calls regarding children under 5 with exposure to these sugar-lowering medicines.
“Sugar-lowering medication, strong anti-inflammatories — these are potent medications. It doesn’t have to be a narcotic,” Schectman said.
And adult doses of those drugs in a child-size body can result in an instant overdose with swift consequences, said Dr. Richard Weisman, director for the Florida Poison Control Center in Miami.
“Hypoglycemics? In a child with a normal blood sugar, it can make it go down to a zero. That’s a coma, seizure and death,” Weisman said. The solution is to get to the hospital where the child can be given glucose intravenously.
While the toddler set is the most vulnerable to accidental poisonings, the Pediatrics study highlights another set of victims as well: teenagers who tend to seek out these prescriptions — often the opioids such as oxycodone — which can be found in Percocet, for example.
The toll on Florida teens has been dramatic, with calls to poison control increasing 369 percent from 2000 to 2009. In 2012, the centers fielded 104 calls involving teens and opiates.
“At least once a week we see that, a teenager takes an overdose of pills,” McFarland said. “It used to be we’d see mostly Tylenol overdoses, but now there are so many more drugs out there.”
Says study author Burghardt: “In families with teenagers, parents need to talk to them about how dangerous it is to take medications not meant for you.”
Burghardt has plans to study further what factors play into poisonings. Until then, she sees a rethinking of child-resistant packaging.
At Safe Kids, they’re campaigning to remind parents that their homes may not be as safe as they think.
Where are children finding medicine?
27 percent on ground or misplaced
20 percent in purses, bags or wallets
20 percent on counters, dressers, tables, nightstands
15 percent in pill boxes or bags
12 percent unknown
6 percent in cabinets or drawers
For help if a child has ingested medicine, or in any poison emergency, call the American Association of Poison Control Centers, 800-222-1222
Source: Safe Kids Worldwide