By Dr. Kenneth Rudd, Grace Cottage Hospital Emergency Department Co-Director
as appeared in the Brattleboro Reformer’s Graceful Health series, March 11, 2016
National Poison Week is March 20-26 this year. For the past 55 years, this event has been held to raise awareness and provide strategies for poison prevention.
The headline used by the National Poison Week Council to announce this year’s event isn’t surprising: “Children Act Fast, So Do Poisons.” Over 90% of poison exposures occur in the home, and certainly, we do need to keep our homes safe so children don’t gain access to dangerous chemicals and medicines. But there’s more to this story than children.
Poisoning is a serious and persistent problem. The Institute of Medicine estimates that the incidence of poisoning in the United States is approximately 4 million cases per year, with 300,000 cases leading to hospitalization. In 2013, 43,982 deaths were caused by drug poisoning. In addition, the U.S. poison control centers received calls for poison exposures for 80,266 animals, so be mindful of your pets too.
For young children, there are fatalities due to poisoning, but fortunately, exposure typically causes minor symptoms, and death is a relatively rare occurrence (26 children under age 12 in 2014), according to the National Poison Control Center.
For adults, the statistics are more sobering. Poisoning is now the leading cause of injury-related death in the United States for adults age 25-64, surpassing both motor vehicle collisions and firearm deaths, according to the American Association of Poison Control Centers (AAPCC). Ninety percent of these poisoning deaths are due to licit and illicit drug poisoning, with the majority coming from prescription medications.
My experience with poisonings treated by the Grace Cottage Hospital Emergency Department is in line with national statistics. These days, most poisonings are due to drug interactions and overdoses, and most are accidental. In 2013, 81% of poisoning deaths were unintentional, 12% were suicides, and 6% were of undetermined intent.
Although they are a relative minority, over 5,000 deaths each year from intentional overdose is a disturbing mental health issue, so we all need to be mindful of each other and try to be aware when someone we know is losing hope.
Among the most common substances responsible for adult poisonings are pain relievers (12.9 percent), sedatives and antipsychotics (11 percent), and antidepressants (6.4 percent).
Since most poisonings from drugs are accidental, the single most important thing you can do to prevent becoming a statistic is to take prescription medicines only if they have been prescribed specifically for you and to carefully follow the directions. Taking a larger dose for whatever reason is not a safe course of action, nor is taking the medicine more often than prescribed. Tylenol (acetaminophen) deserves special mention, not because it can kill you, but because it can certainly kill your liver, with severe damage occurring even from taking just twice as much as directed. In the right doses, without liver disease, Tylenol is extremely safe, even in pregnancy.
Sometimes, problems occur because of adverse interactions between medications, so it’s important to read warning labels on the medications and supplements you take, both over-the-counter items and prescriptions, to learn about these possible interactions. For example, alcohol and controlled anti-anxiety medicines (benzodiazepines) are a common culprit.
With the recent increase in recreational opioid use, there is a health push to make Narcan (naloxone) widely available to the public, as this nasal reversal agent can save the life of someone who becomes unarousable after taking too much of any opiate (for example, oxycodone, heroin, etc.)
It is a very good idea to keep the Poison Control Hotline number always at the ready: 1-800-222-1222. Someone is available to answer calls 24 hours a day, 7 days a week, every day of the year. Posting this phone number in a prominent place in your home, perhaps right next to the phone, and in the contacts of your cell phone, could help save a life. Help is also available at www.poison.org, whether you need help in an emergency, or just want to look up some facts.
Of course, it is appropriate to call 9-1-1 for any emergency, including a poisoning.
Dr. Rudd earned his M.D. and Masters of Public Health degrees from the University of Connecticut. After completing an Academic Medicine Fellowship at the In His Image Family Medicine Residency Program in Tulsa, OK, he received a Master of Health Care Delivery Science from Dartmouth College.
