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2012 Jordan Institute
for Families

Vol. 17, No. 1
March 2012

Preventing Accidental Poisoning Deaths

A mother is panicked to find her toddler barely breathing and listless. A child is traumatized when he loses his father to drug overdose.

As accidental drug poisonings surged over the past decade, stories like these have become all too familiar to social workers, emergency responders, and medical providers. When you consider the scope and nature of this problem, it’s clear child welfare workers can help prevent accidental overdoses and deaths.

Scope of the Problem
Here are some striking national statistics and facts from the Centers for Disease Control and Prevention (2010):

  • We’ve hit an all-time high. Death rates from overdose have never been higher. In 2007 there were 27,658 unintentional overdose deaths in the U.S.
  • The rise has been steep. Between 1999 and 2005 the annual number of unintentional drug overdose deaths in the U.S. more than doubled—from 11,155 to 22,448. Overdose death rates have increased roughly five-fold since 1990.
  • Opioid use has jumped. There has been at least a 10-fold increase in the medical use of opioid painkillers during the last 20 years due to more aggressive pain management by physicians.
  • More deadly than illegal drugs. In 2007, the number of deaths involving opioids was 1.93 times the number involving cocaine and 5.38 times the number involving heroin.

Risk of accidental overdose and death is made worse by the combined use of pharmaceuticals with alcohol or other substances and “doctor shopping,” which occurs when patients obtain prescriptions from multiple physicians with no coordination among the doctors involved. The addictive effects of some prescribed drugs may also increase the likelihood of unintended consequences.

Opioids—synthetic versions of opium—are good candidates for misuse and abuse because they cause euphoria. These drugs are typically prescribed for pain management and can be highly effective, but when taken in excess they can suppress breathing to a fatal degree (CDC, 2010). Challenges faced by patients with opioid prescriptions can include storing the drug safely within the home, negative drug interactions (if they take multiple medications), and the risk of overmedication (if higher than needed dosages are prescribed).

Access to pharmaceuticals for non-medical use also happens through sharing among family or friends, theft, purchase through illicit means, or online vendors who don’t require a prescription. This kind of use is especially risky because it occurs without medical oversight.

Educating Families
The medical community can help reduce the likelihood of overdose by counseling patients about the risk of overdose to themselves and to others (Hall et al., 2008). Child welfare professionals, too, can help by actively educating the families we work with to ensure they have information that will save lives. To prevent accidental overdose, please share the following lifesaving guidelines (NCDHHS, 2010) with the families you work with:

  • Do not use drugs or other illicit substances alone.
  • Do not mix drugs; if using opioids, avoid drinking alcohol and taking benzodiazepine.
  • Do not use drugs if unsure of their potency.
  • Do not use drugs after a period of prolonged nonuse (such as drug rehabilitation or prison).
  • Do not use drugs in ways other than prescribed.
  • Do not use poly-substances, including dietary and herbal supplements, without consulting a physician.
  • Keep medications and chemicals in their original containers and in a safe place.
  • Dispose of medications correctly. Most can be disposed of in the trash. The FDA and EPA recommend placing them in sealable containers mixed with an undesirable substance (e.g., cat litter). Some pharmacies will also take back unused medications. Some medications that may be especially harmful to others, such as opioids, may be safely flushed down a drain or toilet.

In addition, all parents, extended family members, foster parents, and others should take these steps to protect children from accidental poisoning:

  • Save the Carolinas Poison Center phone number, 1-800-222-1222, in your cell phone.
  • Keep all medications and chemicals in childproof cabinets. Don’t store poisonous substances near food.
  • Do not leave children unsupervised in the vicinity of household products or drugs.
  • Do not refer to medications as “candy.”
  • Identify poisonous plants in your house and yard and place them out of reach of children.

Share this information during home visits, post it visibly within the agency, and add it to the agency website.

Additionally, child welfare professionals can work to improve families’ access to a medical professional and to treatment for substance abuse. Knowing that a mental illness or a history of substance abuse can raise the risk for an overdose, help those with these challenges find the critical services for monitoring health and reducing risk factors.

Above all, social workers can bring compassion and concern to families who have experienced the pain of a non-fatal or lethal overdose, and can ensure that the voices of survivors and family members are heard when a community decides how to respond to this complex and challenging public health issue.

References for this and other articles in this issue