How kids are poisoning themselves, and how to prevent it

Common pain and fever medications like ibuprofen and acetaminophen account for a large number of calls to the Ontario Poison Centre. Don Denton / The Canadian Press

Ontario’s Poison Control Centre received over 20,000 calls about children under five in 2013. The top reasons? Household cleaners and fever medication.

About seven per cent of calls related to assorted household cleaning products. Eleven per cent related to ibuprofen and acetaminophen, according to a report from the Poison Control Centre.

“Under the age of five, most children you can’t reason with. They don’t understand, they haven’t got experience, they’re curious, they’re mimicking,” said Dr. Margaret Thompson, medical director of the Ontario Poison Centre.

“In general, the exposures are completely innocent sort of things. They’re just exploring their environment.”

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Exploring their environment could include drinking laundry detergent, or sneaking a swig of their sibling’s fever medication while the bottle is still open and a parent is busy trying to give the other child the proper dose.

“There’s a lot of research about how if there is an ill child in the family, a different sibling misses the attention and so tries to mimic,” she said.

It’s also common for parents to accidentally double-dose their children.

“Mom comes home at 5 p.m. and notices that the child has a fever, so she gives the child a dose of the acetaminophen or ibuprofen, whichever is in the household. And Dad comes home at 5:30 and it hasn’t yet taken effect and the child has a fever still, and so Dad gives the child the same medication and then talks to his wife a half hour later and they discover that they’ve given the child a double-dose of the medication.”

In that case, said Thompson, if a worried parent calls the Poison Centre, the operator will work out the toxic dose based on the child’s weight, and if the amount the child has had is less than that, reassures the parents that the child doesn’t need to visit the hospital, as well as provide some poison prevention tips.

Some useful things to remember include:

  • Anything is a potential toxin – even things like toothpaste or aftershave can be harmful if enough is consumed.
  • Medication should be locked up and kept out of sight.
  • Never take your substances out of their original containers – if something is accidentally swallowed, not having the container handy can make it tough to identify the substance, its concentration and other useful information.
  • To prevent double-dosing, designate one person as the caregiver and have them be the only person who administers medication. Or, keep a schedule on the fridge and make sure that parents sign it anytime they administer a dose.

Child-resistant does not mean child-proof

Don’t rely on child-resistant caps to keep kids out of pill bottles, said Thompson. Even though they’re tough for many adults to manage, the regulations only require that they have a two-step opening mechanism (like squeeze and twist) and that 80 per cent of kids be unable to open it within five minutes.

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“However 20 per cent of kids are probably extraordinary. If they’re determined, they’re going to get into it, either within five minutes or they’re going to get into it over a longer period of time,” she said.

She remembers one call from a parent who said that their child had actually ignored the cap and bitten through the plastic bottle to get at the medication inside. Because a lot of medications are sweetened to make them tolerable, they’re also very attractive to children, she said.

LISTEN: Dr. Margaret Thompson describes her misgivings about candy-like medicines and how they send the wrong message to young children.

It’s safer to make sure that the medications are locked away out of sight.

And one item which kids seem to love, the neon-coloured goo inside glow sticks, is generally not particularly toxic, said Thompson. But she understands why parents might be alarmed by their child’s glowing mouth and call the Poison Centre.

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Teens and pills

Although young children are often exposed to medication accidentally and the Poison Centre gets relatively few calls about kids aged 6-12, with teens, it’s a different story, said Thompson.

Their exposures are far more experimental, she said. They might be pressured into trying things that they know they shouldn’t, or try street drugs. “They have risk-taking behaviour that we all would love to be able to stop.”

As a result, the top reasons why the Poison Centre is contacted about children aged 6-19 are almost exclusively drugs – including prescription drugs.

Atypical antipsychotics are generally used to treat schizophrenia or sometimes bipolar disorder, and accounted for the highest number of prescription drug-related calls in that age group. Benzodiazepenes are a family of drugs which include common sleep aids and anti-anxiety medication such as Xanax and Valium. Also in the top ten are SSRI antidepressants and methylphenidates – which include Concerta and Ritalin.

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“They take medications available to them in the household,” said Thompson. These medications could be their parents’, or their own.

When it comes to an overdose of an anti-depressant, “It would most likely be overdoses for suicidal purposes, unfortunately,” said Thompson.

This could also account for why calls about children aged 0-12 are slightly more likely to be about boys, but calls for teenagers are about girls 70 per cent of the time.

“It’s mostly a reflection of not who’s experimental, but who’s suicidal,” she said. “My interpretation of it is that guys are more likely to commit suicide with a more violent method and females are more likely to use drugs and substances.”

Suspected suicides account for over half of calls to the Poison Centre for children aged 6-19, though there were only six deaths out of nearly 8,000 calls in 2013, including those which may have been the result of an unintentional exposure, not suicide attempts.

Thompson suggests that parents have conversations with their children about the risks of drugs, and perhaps suggest that if they are going to experiment, that there be someone sober present who can call for help.

Also, when it comes to the police, “They’re there to help you,” she said. “I know some kids are worried that if they call 911 the police are going to charge everybody for having used, and that’s not what the police are about. The police are about getting help for the person who’s sick at that time.”

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If you’re worried about a possible poisoning, call 911 or call the Ontario Poison Centre at 1-800-268-9017.

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