Calls to U.S. poison control centers about the inappropriate exposure of children and teens to medications used to treat attention deficit hyperactivity disorder (ADHD) rose significantly between 2000 and 2014, according to a study published this week in the journal Pediatrics.
Although the specific number of calls fluctuated from year to year, people concerned that someone aged 19 or younger had been unsafely exposed to ADHD medications made 156,365 calls to poison control hotlines during the 15 years of the study.
That averages out to 200 calls per week, or 29 per day — or about one every 50 minutes.
Inappropriate exposures include finding and ingesting the medication accidentally, taking it in the wrong dosages, and intentionally overdosing on the medication to either get high or to commit suicide.
The findings of this study should serve as a strong reminder to parents to make sure that all medications in their homes are stored safely and used appropriately.
“Pediatric exposures to ADHD medications are an increasing problem in the U.S., affecting children of all ages,” says Dr. Gary Smith, the study’s senior author and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, in a released statement. “We need to do more to prevent these exposures.”
As background information in the study points out, ADHD is the most commonly diagnosed neurobehavioral disorder among young people in the United States. An estimated 6.4 million American children and teens have been diagnosed with ADHD, and about 70 percent of those children are treated with medications.
In a previous study, researchers found that U.S. poison control centers received more than 25,000 calls in 2015 regarding the exposure of people of all ages to just two drugs frequently prescribed for ADHD: amphetamine and methylphenidate.
Another study reported that visits to hospital emergency departments for exposures to ADHD medications by people of all ages increased 134 percent from 2005 to 2010.
For the current study, Smith and his co-authors decided to look at calls being made to poison control centers regarding the inappropriate exposure of children and teens to ADHD medications.
They used 2010-2014 data from the National Poison Data System, which keeps information about all phone calls placed to the various American Association of Poison Control Centers across the country.
“We wanted to know if the number of calls to poison control centers regarding exposures to these medications was also increasing,” says Smith in a video released with the study. “We also wanted to know what the characteristics of these exposures were.”
The researchers found that the overall rate of reported exposures to ADHD medications among children and teens increased 71.2 percent from 2000 to 2011. There were two periods of slight decline, including a 6.2 percent decrease from 2011 to 2014. Smith and his co-authors stress, however, that it’s too early to know if that dip in the rate reflects a permanent trend.
The most common symptoms reported to the poison control centers in connection with exposure to ADHD medications were agitation and irritability, followed by a rapid heart rate, drowsiness and lethargy, high blood pressure and vomiting. Almost half (45 percent) of the exposures involved methylphenidate and amphetamine medications.
“The increasing number and rate of reported ADHD medication exposures during the study period is consistent with the increasing trends in ADHD diagnosis and medication prescribing,” says Smith.
The majority of the ADHD-medication calls involved boys (65.3 percent) and children aged 12 or younger (76 percent). More than eight in 10 of the calls were for unintentional exposures, including dosage errors (usually involving a double dose of the medication). But half of the exposures among young people aged 13 to 19 were intentional, including attempts at suicide.
Most of the children and teens (60.4 percent) did not receive treatment for their exposure, but slightly more than 6 percent were admitted to a hospital, and there were three deaths.
“Exposures among teens were more likely to result in serious medical outcomes than among other children,” says Smith. All three of the deaths were among teens and involved intentional misuse of the medications.
Smith and his co-authors outline several strategies for reducing inappropriate exposures to ADHD medications, including more aggressive efforts at educating parents and teenagers about how to safely use, store and dispose of these medications. They also recommend greater use of non-drug treatments for ADHD.
FMI: You’ll find an abstract of the study on the Pediatrics website, but the full study is behind a paywall. For information about the safe storage of medications, go to the American Academy of Family Physicians’ website. The information is not just for parents. Anybody who has children come into their homes — grandparents, for example — should make sure all medications are stored safely.