Thousands of children accidentally ingest dangerous prescription drugs every year. Yet few people take the needed precautions that could protect kids from drug poisoning.
A new Consumer Reports Best Buy Drugs nationally representative survey of 1,006 American adults found that only 2 in 10 who have dangerous medications—such as opioid pain pills, stimulants used to treat ADHD, and sedatives—lock them up.
That could help explain why nearly 60,000 kids under the age of 5 accidentally ingest these dangerous drugs every year and wind up in emergency rooms, according to data from the Centers for Disease Control and Prevention (CDC).
With today being National Spring Clean Your Medicine Cabinet Day, it's important to be aware of the dangers of prescription drugs and know the best ways to keep your kids away from them.
Children get their hands on pills or liquid medicine by finding them around the house—left out on kitchen countertops or by a bedside to be used later, says Dan Budnitz, M.D., M.P.H., director of the CDC's Medication Safety Program.
Parents either don't take the needed precautions to store them safely away, or they assume child-safety caps and devices will deter kids from trying to get into them, he notes.
Parents also underestimate the harm to a child from ingesting even a single pill, says Budnitz. “For certain long-acting opioids, for instance, one pill can be a fatal dose for a child," he explains.
Opioid-containing pills like hydrocodone (Vicodin), oxycodone (Percocet), and buprenorphine (Suboxone) top the list as drugs most likely to be accidentally ingested, followed by anti-anxiety drugs like clonazepam (Klonopin) and lorazepam (Ativan), says Budnitz.
Those drugs could cause a child to become unconscious or even stop breathing, or could trigger seizures. If any of these happen to your child, or he or she seems overly sleepy, confused, has difficulty breathing, or has stopped breathing, call 911 immediately.
Then check the child's mouth and remove any pills. Get the bottle and remaining pills so that emergency personnel can identify what they were and give the best treatment or antidote.
If you suspect an opioid pain pill is the culprit, emergency responders can administer the opioid reversal drug naloxone. Your child will still need to be taken to an emergency room for further evaluation and possible treatment.
Acetaminophen (in Tylenol and other products), the widely used fever and pain reducer, is the most common accidentally ingested over-the-counter drug. It can cause liver damage or liver failure when taken in doses that are too high for a child.
These risks are why the CDC recommends treating all drugs like any other potentially dangerous household chemical and locking up or storing all medicine away from children, all the time.
To reinforce the suggestions, the CDC recently started Up and Away, an initiative that reminds people to never leave pills or medicine bottles lying around on tables, nightstands, or countertops, in purses, bags, or coat pockets. And never tell children that their medication is “candy.”
Child-resistant caps on medicine bottles have been around since the 1970s, but child-resistant does not mean child-proof.
“Child-resistant caps don’t work unless adults use them properly by completely re-closing them immediately after each and every use,” says Maribeth Lovegrove, M.P.H., an epidemiologist in CDC’s Medication Safety Program.
“When the child-resistant cap is not completely closed, we’ve found that many young children can easily access the bottle contents,” notes Lovegrove.
Instead of relying exclusively on the safety caps, Lovegrove suggests that innovative safety packaging like child-resistant “blister packs” could help to prevent unsupervised ingestions for certain high-risk medicines because each dose of medicine is individually sealed. These can be more difficult for children to open and reduces the chance that children will swallow a pill they are not supposed to.
Not every pharmacy can fill prescriptions in blister packs, but it is worth asking. An online pharmacy service based in New Hampshire called PillPack can fill prescriptions in personalized, individualized plastic packs (they ship to all 50 states except Hawaii).
To combat acetaminophen overdoses, drugmakers recently added a small plastic safety device to the opening of liquid medicine bottles. It’s called a flow restrictor, and it limits the amount of fluid that a person can pour out, even when the cap is off and the bottle is turned upside down, shaken, or squeezed.
That prevents a child from getting a large volume of liquid medicine quickly from a bottle, which limits the risk of an overdose.
In 2013, Consumer Reports tested flow restrictors on more than 30 infant and children’s liquid acetaminophen bottles. Our tests confirmed that this feature added an extra layer of protection against acetaminophen poisoning, making it more difficult for children to pour out and drink liquid medicine.
The CDC’s own studies also show something similar: Without a flow restrictor and with an improperly locked safety cap, 82 percent of kids could empty a bottle in under 2 minutes; with a flow restrictor in place and without any safety cap, a mere 6 percent of kids could could completely empty the bottle by the end of the 10-minute test.
Ideally, adding a flow restrictor to any liquid medication bottle will lessen the risk of accidental ingestion.
Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).