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National Poison Control Center data from 2012 show that poisonings from prescription drugs are the leading cause of injury death in the United States, and that poisonings from “bath salts,” synthetic marijuana and laundry detergent pods are emerging threats to public health. The paper was published online Monday in Annals of Emergency Medicine.
“The poison center system can provide real-time advice and collect data regarding a variety of poisonings, including those that may be new or unfamiliar to emergency physicians,” said lead study author Richard Dart, MD, PhD, of the Rocky Mountain Poison and Drug Center in Denver, Colo. “Emergency physicians are continually challenged by the emergence of new types of poisonings, which lately include illicit street drugs as well as laundry detergent pods. The National Poison Data System (NPDS) plays an integral role in helping EMS and emergency departments respond to these dangerous substances.”
In 2012, poison centers across the country recorded 2.2 million human poison exposures. Most patients who contacted a poison center were managed without involving a health care facility, such as a hospital emergency department. Involvement of a medical facility for poisonings increased with patient age: In 2012, 11.6 percent of children under 5, 14 percent of children age 6 to 12, 51.2 percent of teenagers and 37.9 percent of adults were treated in a health care facility for poisonings.
The majority (83 percent) of poisonings that ended in death in 2012 were linked to a pharmaceutical product, most commonly opioid painkillers, though NPDS also recorded deaths from cardiovascular and antidepressant medications. The total number of prescription opioid exposures by children more than doubled between 2002 and 2012 (from 2,591 to 5,541). Non-pharmaceutical agents also led to poisoning deaths, with carbon monoxide the leading cause of death in this category.
In 2012, a new source of poisonings among children emerged in the form of laundry detergent pods, though the adverse effects are generally not life-threatening. The family of designer drugs such as “bath salts” (a type of amphetamine), “plant food,” synthetic marijuana and others continue to poison users severely enough that they require emergency medical treatment. Although bath salts exposures peaked in 2011, new illicit drugs sold to consumers continue to be monitored by poison control centers.
“Poisoning continues to be a significant cause of injury and death in the United States,” said Dr. Dart. “The near real-time responsiveness of NPDS helps emergency physicians respond to new poisoning threats, while also assisting patients who call for help to know when they need the ER and when they can manage things safely at home.”
- Richard C. Dart, Alvin C. Bronstein, Daniel A. Spyker, Louis R. Cantilena, Steven A. Seifert, Stuart E. Heard, Edward P. Krenzelok. Poisoning in the United States: 2012 Emergency Medicine Report of the National Poison Data System.Annals of Emergency Medicine, 2014; DOI: 10.1016/j.annemergmed.2014.11.001