A study presented at the Pediatric Academic Societies annual meeting in Denver and reported by Bloomberg Businessweek: http://www.businessweek.com/lifestyle/content/healthday/652405.html found that for children younger than 2 months, the prescribed dosage for narcotics was too high 40 percent of the time.
The study reviewed more than 50,000 prescriptions for narcotic-containing drugs given to kids up to age 3 and found about 4 percent were given an overdose.
The rate was much higher among the youngest babies, according to the study.
“Almost one in 10 of the youngest infants, ages 0 to 2 months, received more than twice the dose that they should have received based on their age, gender and a conservative estimate of their weight,” the study’s lead researcher, Dr. William T. Basco Jr., director of the division of general pediatrics at the Medical University of South Carolina, said in a news release from the American Academy of Pediatrics.
“Since we know that parents have difficulty measuring doses of liquid medication accurately,” Basco said, “it is critical to strive for accurate narcotic prescribing by providers and dispensing by pharmacies.”
The researchers analyzed the prescriptions of 19 drugs given to children enrolled in Medicaid from 2000 to 2006. They calculated the proper daily dose of each drug — based on a child’s weight, age and sex — and examined whether they got the correct dose.
The youngest kids were most likely to get an overdose of a drug, Basco said. Among children who were younger than 2 months, about four in 10 received an overdose. The percentage of overdoses was 3 percent in kids older than a year, the study found.
The overdoses were significantly higher than the proper doses — for an average child, for instance, about 42 percent larger than they should have been, the study reported.
Narcotic drugs such as codeine and hydrocodone can be dangerous for infants and children because of their sedative effects, the researchers noted.
From the American Association of Poison Control Centers:
For Immediate Release April 13, 2011
American Association of Poison Control Centers: Poison Centers Federal Appropriations Cut by Nearly 25 percent in Proposed FY 2011 Continuing Resolution; Damaging Impact to States’ Ability to Help Citizens
Alexandria, Va. –U.S. poison centers suffered a nearly 25 percent cut in federal dollars in the proposed 2011 fiscal year continuing resolution agreed upon by House and Senate negotiators and released publicly on Tuesday – a damaging cut, but one far less brutal than originally proposed by the House of Representatives in H.R. 1.
The House of Representatives, in H.R. 1, had originally called for a 93 percent reduction in federal funding for America’s poison control system, a move that would have produced disastrous effects on public health.
“We’re grateful that Congress has recommended that a majority of our 2011 federal dollars be restored in the final compromise,” said Richard Dart, M.D., Ph.D., president of the American Association of Poison Control Centers. “But we must be clear: These cuts are still extremely harmful for poison centers. The cuts come on top of budget cuts at the state level. Many centers are experiencing total cuts from all sources of 40 percent or more. It’s short-sighted to believe that centers can sustain these cuts and continue to provide the same level of service that they did before.”
Federal dollars account for roughly 20 percent of total funding for poison centers, with states and other non-federal sources funding most of the balance. Poison centers provide free and confidential medical advice 24 hours a day, seven days a week, and have been cited as a model for cost-effective health care delivery.
“These cuts come during a time when poison centers are already facing enormous financial strain,” Dart said. “It’s too soon to know what these cuts mean. At best, callers to poison centers may have to wait longer before talking to a medical expert. At worst, we may see more of our poison centers close.”
In 2010, the state of New York closed three of its five poison centers, citing budgetary issues. In 2009, Michigan closed one of its two centers. New Mexico has seen a 29 percent reduction in state support over the past three years. Poison centers in California, Illinois, New Jersey and Washington have also fought tough battles in recent years to preserve funding.
A 2008 study conducted in Arizona and published in the Journal of Medical Toxicology found that poison centers saved $33 million in state-funded health care costs in one year, and that for every dollar the state of Arizona spent on the poison center, it saved about $36 in unnecessary health care charges.
According to some estimates, for a total yearly operating cost of less than $150 million, U.S. poison centers save more than $1 billion dollars in avoided health care costs. This doesn’t include other benefits, such as higher quality and more efficient care of poisoned patients, local, state and federal public health collaboration, professional and public education, regionally-related research and governmental consultation, to name a few.
According to the Centers for Disease Control and Prevention, accidental poisoning is the second-leading cause of unintentional injury death in the United States, trailing only automobile accidents. U.S. poison centers received more than four million calls in 2009, offering free, confidential information and professional medical advice to those exposed to poisons ranging from carbon monoxide to snake bites to food poisoning.
“Poisoning remains a very real public health threat,” said Jim Hirt, executive director of the American Association of Poison Control Centers. “But poison centers help reduce the cost of poison exposures. Nearly 91 percent of human exposure cases handled by a poison center are kept from having to go to a health care facility. Doctors, nurses and other medical professionals rely on poison centers every day for professional advice.”
In recent years, poison centers have emerged as a leader in public health surveillance, thanks to the National Poison Data System, a system that tracks all toxic exposures and certain public health emergency data reported to U.S. poison centers.
That system in 2010 helped collect invaluable data for public health agencies on the impact of the Gulf Oil spill. More recently, it has tracked radiation exposures and provided public health information, as requested by the U.S. Centers for Disease Control, linked to the earthquake in Japan. Poison centers were also the first to raise the alarm about the toxic effects of synthetic marijuana and psychoactive products marketed as bath salts.
Currently, 57 poison centers cover all 50 states as well as the District of Columbia, Puerto Rico, American Samoa, the Federated States of Micronesia, Guam and the U.S. Virgin Islands.
About the American Association of Poison Control Centers: The American Association of Poison Control Centers supports the nation’s 57 poison centers in their efforts to treat and prevent poisoning. Poison centers offer free, confidential medical advice 24 hours a day, seven days a week. If you have questions about poisons, or you believe you’ve been exposed to something that could be bad for you, call your poison center at 1-800-222-1222.
Contact: Jessica Wehrman
wehrman@aapcc.org
(703) 894-1863
www.aapcc.org
A new study by researchers at the Center for Injury Research and Policy of The Research Institute at Nationwide Children’s Hospital examined emergency department (ED) visits for drug-related poisonings and found that in just one year (2007) in the U.S., there were approximately 700,000 ED visits costing nearly $1.4 billion in ED charges alone. This equates to an average of 1,900 drug-related ED visits and $3.8 million in ED charges each and every day in this country.
“The magnitude of these findings is staggering,” said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital. “The number and cost of drug-related poisonings identified in this study indicate a public health emergency that requires a decisive and coordinated response at national, state and local levels.”
Misuse of prescription drugs by adults is the main cause of the epidemic, but children are at risk too.
Of concern to us was the study’s finding that children 5 years and younger had a higher rate of ED visits for unintentional drug-related poisonings than all other age groups.
“Despite the fact that successful prevention strategies targeted at young children have helped to decrease the occurrence of drug-related poisonings in this population, the number of unintentional poisonings among this age group is still too high,” said Dr. Smith. “Our findings reinforce the importance of increasing efforts to prevent unintentional drug exposures among young children in the United States.”
Here is the citation:
Am J Emerg Med. 2011 Feb 28. [Epub ahead of print]
