‘Extremely worrying’ spike in kids swallowing others’ medicines

The incidence of seizures in children and adolescents caused by ingesting prescription medications or illicit drugs has doubled in the last 15 years, according to new research.
 
The United States data was presented at the European Emergency Medicine Congress this month, serving as a timely reminder for GPs of the potential consequences of accidental poisoning in young people.
 
It found that, in the US, the overall number of toxin-related seizures jumped from 1418 in 2009 to 2749 in 2023, with numbers doubling for those aged 6–19 years and increasing by 45% in children under six years old.
 
The substances responsible for most of this increase include diphenhydramine, tramadol, bupropion, and illegal synthetic cannabinoids.
 
The three pharmaceutical substances are commonly used in Australia, with antihistamine diphenhydramine available for purchase over the counter in syrup and tablet form.
 
Tramadol is a strong opioid prescription medication commonly used for severe pain, and bupropian was previously used widely in Australia as a smoking cessation aid and remains available either alone or in conjunction with other pharmaceuticals.
 
The study highlights the severe risks of some over-the-counter and prescription medications as well as the dangers young people may be exposed to when illegal substances are in their home.
 
Professor Mark Morgan, Chair of RACGP Expert Committee – Quality Care, told newsGP the research highlights the importance of GPs reminding patients to keep their medicines safely out of reach of children.
 
‘It is unclear why there has been an increase in children presenting after a seizure associated with swallowing medication,’ he said.
 
‘For parents of young children there is a need to be aware that visitors to the house might bring medicines and that these need to be kept in a safe location too.
 
‘If a parent or carer suspects a child might have taken medicines there is a need to take action and not wait for the child to become unwell.’
 
Researcher Professor Christopher Holstege described the study’s results as ‘extremely worrying’ and said they must be addressed.
 
‘It’s a stark reminder to parents and carers to store medications safely so that children cannot get hold of them,’ he said.
 
In 2001, an Australian Institute of Health and Welfare report listed anticoagulants and psychoactive medications as causing the most morbidity in pre-school children.
 
A similar review of emergency department attendees in Queensland listed paracetamol as the most common agent.
 
GPs have an important role to play in providing emergency, follow up, and continuing care for patients with seizures, with the research highlighting the need to have an awareness of the possible causes, including the ingestion of substances, crucial.
 
However, GPs are not always privy to the range of health products patients purchase over the counter or from other health practitioners.
 
The study highlights that maintaining a comprehensive understanding of what medications or alternative preparations, and drugs of addiction individuals and households are using, will enable positive engagement and education about potential risks to children and young people.
 
Professor Morgan said there is also an important role for pharmacists to provide advice about safe storage and disposal as part of dispensing.
 
‘Polypharmacy and prescriptions for psychoactive medications in adults is very common, so perhaps it is the increased amount of medicines in the home that is to blame,’ he said.
 
The research team gathered information on seizures caused by exposure to any single substance, collected from the US National Poison Data System which collates information from 55 poisons centres.
 
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