The Experts below are selected from a list of 4407 Experts worldwide ranked by ideXlab platform
Gary A Smith - One of the best experts on this subject based on the ideXlab platform.
-
suicide related over the counter analgesic exposures reported to united states Poison Control Centers 2000 2018
Pharmacoepidemiology and Drug Safety, 2020Co-Authors: Henry A Spiller, Gary A Smith, Alexandra G Hopkins, Sandhya Kistamgari, Nichole L Michaels, Alexandra R FunkAbstract:PURPOSE To investigate suicide-related over-the-counter (OTC) analgesic medication exposures among individuals ≥6 years old reported to United States (US) Poison Control Centers. METHODS Data from the National Poison Data System for the years 2000-2018 were retrospectively analyzed. RESULTS From 2000 to 2018, US Poison Control Centers recorded 549 807 suicide-related cases involving OTC analgesics, including 327 781 cases (59.6%) admitted to the hospital and 1745 deaths (0.3%). Most cases involved a single substance (67.5%) and occurred among females (72.7%) and individuals 6-19 years old (49.7%). Overall, the rate of exposures increased significantly by 33.5% from 2000 to 2018, primarily driven by the increasing exposure rate among 6- to 19-year-old females. From 2000 to 2018, exposure rates for acetaminophen and ibuprofen increased, while that for acetylsalicylic acid decreased. Additionally, the proportion of cases resulting in a serious medical outcome or healthcare facility admission increased for all types of OTC analgesics. Acetaminophen and acetylsalicylic acid accounted for 48.0% and 18.5% of cases, respectively, and 64.5% and 32.6% of deaths, respectively. Both acetaminophen and acetylsalicylic acid had greater odds of healthcare facility admission (ORs 2.56 and 2.63, respectively) and serious medical outcomes (ORs 2.54 and 4.90, respectively) compared with ibuprofen. CONCLUSIONS The rate of suicide-related OTC analgesic cases is increasing. Acetaminophen and acetylsalicylic acid cases are associated with greater morbidity and mortality. Prevention efforts should include implementing unit-dose packaging requirements and restrictions on package sizes and purchase quantities for acetaminophen and acetylsalicylic acid products to reduce access to large quantities of these analgesics.
-
ocular exposures reported to united states Poison Control Centers
Ophthalmic Epidemiology, 2019Co-Authors: Alisha Kamboj, Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Gary A SmithAbstract:Purpose: To investigate the epidemiology of ocular exposures reported to Poison Control Centers in the United States.Methods: A retrospective analysis of ocular exposures from 2000 to 2016 was cond...
-
kratom exposures reported to united states Poison Control Centers 2011 2017
Clinical Toxicology, 2019Co-Authors: Sara Post, Henry A Spiller, Thitphalak Chounthirath, Gary A SmithAbstract:AbstractContext: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety.Methods: This study analyzes exposures to kratom reported to Poison Control Centers (PCCs) in the United States during 2011–2017 from the National Poison Data System (NPDS).Discussion: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016–2017. Most exposures occurred among adults ≥20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21–3.55) and a serious medical outcome (OR: 2.25; 9...
-
buprenorphine exposures among children and adolescents reported to us Poison Control Centers
Pediatrics, 2018Co-Authors: Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Gary A Smith, Sara PostAbstract:OBJECTIVE: To investigate buprenorphine exposures among children and adolescents ≤19 years old in the United States. METHODS: Data were analyzed from calls to US Poison Control Centers for 2007–2016 from the National Poison Data System. RESULTS: From 2007 to 2016, there were 11 275 children and adolescents ≤19 years old exposed to buprenorphine reported to US Poison Control Centers. Most exposures were among children CONCLUSIONS: Buprenorphine is important for the treatment of opioid use disorder, but pediatric exposure can result in serious adverse outcomes. Manufacturers should use unit-dose packaging for all buprenorphine products to help prevent unintentional exposure among young children. Health providers should inform caregivers of young children about the dangers of buprenorphine exposure and provide instructions on proper medication storage and disposal. Adolescents should receive information regarding the risks of substance abuse and misuse. Suspected suicide accounted for 12% of adolescent exposures, highlighting the need for access to mental health services for this age group.
-
pediatric adhd medication exposures reported to us Poison Control Centers
Pediatrics, 2018Co-Authors: Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Gary A Smith, Samantha King, Nichole L HodgesAbstract:OBJECTIVES: To describe the characteristics and trends of exposures to attention-deficit/hyperactivity disorder (ADHD) medications among individuals 0 to 19 years old reported to US Poison Control Centers. METHODS: National Poison Data System data from 2000 through 2014 were retrospectively analyzed to examine pediatric ADHD medication exposures. RESULTS: From 2000 through 2014, there were 156 365 exposures reported to US Poison Control Centers related to ADHD medications. The overall rate of reported exposures increased 71.2% from 2000 to 2011, followed by a 6.2% decrease from 2011 to 2014. Three-fourths (76.0%) of exposures involved children ≤12 years old. Methylphenidate and amphetamine medications accounted for 46.2% and 44.5% of exposures, respectively. The most common reason for exposure was therapeutic error (41.6%). Intentional medication exposures (including suspected suicide and medication abuse and/or misuse) were reported most often among adolescents (13–19 years old), accounting for 50.2% of exposures in this age group. Overall, the majority of exposed individuals (60.4%) did not receive health care facility treatment; however, 6.2% were admitted to a hospital for medical treatment, and there were 3 deaths. The increasing number and rate of reported ADHD medication exposures during the study period is consistent with increasing trends in ADHD diagnosis and medication prescribing. Exposures associated with suspected suicide or medication abuse and/or misuse among adolescents are of particular concern. CONCLUSIONS: Unintentional and intentional pediatric exposures to ADHD medications are an increasing problem in the United States, affecting children of all ages.
Daniel A Spyker - One of the best experts on this subject based on the ideXlab platform.
-
2017 annual report of the american association of Poison Control Centers national Poison data system npds 35th annual report
Clinical Toxicology, 2018Co-Authors: David D Gummin, Daniel E Brooks, James B Mowry, Daniel A Spyker, Krista M Osterthaler, William BannerAbstract:Introduction: This is the 35th Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of 1 January 2017, 55 of the nation’s Poison cente...
-
2016 annual report of the american association of Poison Control Centers national Poison data system npds 34th annual report
Clinical Toxicology, 2017Co-Authors: David D Gummin, Daniel E Brooks, James B Mowry, Daniel A Spyker, Michael O Fraser, William BannerAbstract:AbstractIntroduction: This is the 34th Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of 1 January 2016, 55 of the nation’s Poison Centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.50 [7.33, 14.6] (median [25%, 75%]) min, facilitating a near real-time national exposure and information database and surveillance system.Methods: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Cases with medical outcomes of death were evaluated by a team of medical and clinical toxicologist reviewers using an ordinal scale of 1–6 to assess the Relative Contribution to Fatality (RCF) of the exposure.Results: In 2016, 2,710,042 closed encounters were logged by NPDS: 2,159,032 human exposures, 54,019 animal exposures, 490,215 information cases, 6687 human confirmed non-exposures, and 89 animal con...
-
2015 annual report of the american association of Poison Control Centers national Poison data system npds 33rd annual report
Clinical Toxicology, 2016Co-Authors: James B Mowry, Daniel E Brooks, Daniel A Spyker, Ashlea Zimmerman, Jay L SchaubenAbstract:AbstractIntroduction: This is the 33rd Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of 1 January 2015, 55 of the nation’s Poison Centers (PCs) uploaded case data automatically to NPDS. The upload interval was 9.52 [7.40, 13.6] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system.Methods: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of medical and clinical toxicologist reviewers using an ordinal scale of 1-6 to assess the Relative Contribution to Fatality (RCF) of the exposure.Results: In 2015, 2,792,130 closed encounters were logged by NPDS: 2,168,371 human exposures, 55,516 animal exposures, 560,467 information calls, 7657 human confirmed nonexposures, and ...
-
2014 annual report of the american association of Poison Control Centers national Poison data system npds 32nd annual report
Clinical Toxicology, 2015Co-Authors: James B Mowry, Daniel E Brooks, Daniel A Spyker, Naya Mcmillan, Jay L SchaubenAbstract:ABSTRACTBackground: This is the 32nd Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of 1 January 2014, 56 of the nation’s Poison Centers (PCs) uploaded case data automatically to NPDS. The upload interval was 7.82 [7.02, 11.17] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of medical and clinical toxicologist reviewers using an ordinal scale of 1–6 to assess the Relative Contribution to Fatality (RCF) of the exposure to the death.Results: In 2014, 2,890,909 closed encounters were logged by NPDS: 2,165,142 human exposures, 56,265 animal exposures, 663,305 information calls, 6,085 human confirmed n...
-
2012 annual report of the american association of Poison Control Centers national Poison data system npds 30th annual report
Clinical Toxicology, 2013Co-Authors: James B Mowry, Daniel A Spyker, Louis R Cantilena, Elise J Bailey, Marsha FordAbstract:AbstractBackground: This is the 30th Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of July 1, 2012, 57 of the nation's Poison Centers (PCs) uploaded case data automatically to NPDS. The upload interval was 7.58 [6.30, 11.22] (median [25%, 75%]) min, creating a near real-time national exposure and information database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of 34 medical and clinical toxicologist reviewers using an ordinal scale of 1–6 to assess the Relative Contribution to Fatality (RCF) of the exposure to the death.Results: In 2012, 3,373,025 closed encounters were logged by NPDS: 2,275,141 human exposures, 66,440 animal exposures, 1,025,547 information calls, 5,679 human confirmed no...
Alvin C Bronstein - One of the best experts on this subject based on the ideXlab platform.
-
2011 annual report of the american association of Poison Control Centers national Poison data system npds 29th annual report
Clinical Toxicology, 2012Co-Authors: Alvin C Bronstein, Daniel A Spyker, Louis R Cantilena, Barry H Rumack, Richard C DartAbstract:AbstractBackground: This is the 29th Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of 1 July 2011, 57 of the nation's Poison Centers (PCs) uploaded case data automatically to NPDS. The upload interval was 8.43 [6.29, 13.7] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of 38 medical and clinical toxicologist reviewers using an ordinal scale of 1–6 to assess the Relative Contribution to Fatality (RCF) of the exposure to the death.Results: In 2011, 3,624,063 closed encounters were logged by NPDS: 2,334,004 human exposures, 80,266 animal exposures, 1,203,282 information calls, 6,243 human confirmed ...
-
2010 annual report of the american association of Poison Control Centers national Poison data system npds 28th annual report
Clinical Toxicology, 2011Co-Authors: Alvin C Bronstein, Daniel A Spyker, Louis R Cantilena, Jody L Green, Barry H Rumack, Richard C DartAbstract:AbstractBackground: This is the 28th Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). All US Poison Centers upload case data automatically with a median time interval of 19.0 [11.9, 40.6] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of 33 medical and clinical toxicologist reviewers using an ordinal scale of 1 (Undoubtedly responsible) – 6 (Unknown) to determine Relative Contribution to Fatality (RCF) of the exposure to the death.Results: In 2010, 3,952,772 closed encounters were logged by NPDS: 2,384,825, human exposures, 94,823 animal exposures, 1,466,253 information calls, 6537 human confirmed none...
-
2009 annual report of the american association of Poison Control Centers national Poison data system npds 27th annual report
Clinical Toxicology, 2010Co-Authors: Alvin C Bronstein, Daniel A Spyker, Louis R Cantilena, Jody L Green, Barry H Rumack, Sandra L GiffinAbstract:Background: This is the 27th Annual Report of the American Association of Poison Control Centers' (AAPCC) National Poison Data System (NPDS). As of 1 July 2009, 60 of the nation's 60 US Poison Centers (PCs) uploaded case data automatically. The upload time was 19.9 [9.7, 58.7] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of 29 medical and clinical toxicologist reviewers using an ordinal scale of 1-6 to determine Relative Contribution to Fatality (RCF) of the exposure to the death. Results: In 2009, 4,280,391 calls were captured by NPDS: 2,479,355 closed human exposures, 116,408 animal exposures, 1,677,403 information calls, 6,882 human confirmed nonexposures,...
-
the role of clinical toxicologists and Poison Control Centers in public health
American Journal of Preventive Medicine, 2010Co-Authors: Mark E Sutter, Alvin C Bronstein, Stuart E Heard, Claudia L Barthold, James Lando, Lauren Lewis, Joshua G SchierAbstract:Background Poison Control Centers and clinical toxicologists serve many roles within public health; however, the degree to which these entities collaborate is unknown. Purpose The objective of this survey was to identify successful collaborations of public health agencies with clinical toxicologists and Poison Control Centers. Four areas including outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to Poison Control center resources were assessed. Methods An online survey was sent to the directors of Poison Control Centers, state epidemiologists, and the most senior public health official in each state and selected major metropolitan areas. This survey focused on three areas: service, structure within the local or state public health system, and remuneration. Questions regarding remuneration and Poison Control center location within the public health structure were asked to assess if these were critical factors of successful collaborations. Senior state and local public health officials were excluded because of a low response rate. The survey was completed in October 2007. Results A total of 111 respondents, 61 Poison Control Centers and 50 state epidemiologists, were eligible for the survey. Sixty-nine (62%) of the 111 respondents, completed and returned the survey. Thirty-three (54%) of the 61 Poison Control Centers responded, and 36 of the 50 state epidemiologists (72%) responded. The most frequent collaborations were terrorism preparedness and epidemic illness reporting. Additional collaborations also exist. Important collaborations exist outside of remuneration or Poison Control Centers being a formal part of the public health structure. Conclusions Poison Control Centers have expanded their efforts to include outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to Poison Control center resources. Collaboration in these areas and others should be expanded.
-
2008 annual report of the american association of Poison Control Centers national Poison data system npds 26th annual report
Clinical Toxicology, 2009Co-Authors: Alvin C Bronstein, Daniel A Spyker, Louis R Cantilena, Jody L Green, Barry H Rumack, Sandra L GiffinAbstract:Background: This is the 26th Annual Report of the American Association of Poison Control Centers (AAPCC; http://www. aapcc.org) National Poison Data System (NPDS). During 2008, 60 of the nation's 61 US Poison Centers uploaded case data automatically. The median upload time was 24 [7.2, 112] (median [25%, 75%]) minutes creating a real-time national exposure and information database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center cases with medical outcomes of death were evaluated by a team of 28 medical and clinical toxicologist reviewers using an ordinal scale of 1–6 to determine Relative Contribution to Fatality (RCF) from the exposure to the death.Results: In 2008, 4,333,012 calls were captured by NPDS: 2,491,049 closed human exposure cases, 130,495 animal exposures, 1,703,762 information calls, 7,336 human confirmed non...
Stuart E Heard - One of the best experts on this subject based on the ideXlab platform.
-
the role of clinical toxicologists and Poison Control Centers in public health
American Journal of Preventive Medicine, 2010Co-Authors: Mark E Sutter, Alvin C Bronstein, Stuart E Heard, Claudia L Barthold, James Lando, Lauren Lewis, Joshua G SchierAbstract:Background Poison Control Centers and clinical toxicologists serve many roles within public health; however, the degree to which these entities collaborate is unknown. Purpose The objective of this survey was to identify successful collaborations of public health agencies with clinical toxicologists and Poison Control Centers. Four areas including outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to Poison Control center resources were assessed. Methods An online survey was sent to the directors of Poison Control Centers, state epidemiologists, and the most senior public health official in each state and selected major metropolitan areas. This survey focused on three areas: service, structure within the local or state public health system, and remuneration. Questions regarding remuneration and Poison Control center location within the public health structure were asked to assess if these were critical factors of successful collaborations. Senior state and local public health officials were excluded because of a low response rate. The survey was completed in October 2007. Results A total of 111 respondents, 61 Poison Control Centers and 50 state epidemiologists, were eligible for the survey. Sixty-nine (62%) of the 111 respondents, completed and returned the survey. Thirty-three (54%) of the 61 Poison Control Centers responded, and 36 of the 50 state epidemiologists (72%) responded. The most frequent collaborations were terrorism preparedness and epidemic illness reporting. Additional collaborations also exist. Important collaborations exist outside of remuneration or Poison Control Centers being a formal part of the public health structure. Conclusions Poison Control Centers have expanded their efforts to include outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to Poison Control center resources. Collaboration in these areas and others should be expanded.
-
2007 annual report of the american association of Poison Control Centers national Poison data system npds 25th annual report
Clinical Toxicology, 2008Co-Authors: Alvin C Bronstein, Daniel A Spyker, Louis R Cantilena, Jody L Green, Barry H Rumack, Stuart E HeardAbstract:BACKGROUND: This report is the 25th Annual Report of the American Association of Poison Control Centers (AAPCC; http://www.aapcc.org) National Poison Data System (NPDS). During 2007, 60 of the nation's 61 U.S. Poison Centers upload case data automatically. The median upload time is 14 [5.3, 55] (median [25%, 75%]) min creating a real-time national exposure database and surveillance system. METHODOLOGY: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Fatalities were reviewed by a team of 29 medical and clinical toxicologists and assigned to 1 of 6 categories according to Relative Contribution to Fatality. RESULTS: Over 4.2 million calls were captured by NPDS in 2007: 2,482,041 human exposure calls, 1,602,489 information requests, and 131,744 nonhuman exposure calls. Substances involved most frequently in all human exposures were analgesics (12.5% of all exposures). The most common exposures in children less than age 6 were cosmetics/personal care products (10.7% of pediatric exposures). Drug identification requests comprised 66.8% of all information calls. NPDS documented 1,597 human fatalities. CONCLUSIONS: Poisoning continues to be a significant cause of morbidity and mortality in the United States NPDS represents a valuable national resource to collect and monitor U.S. Poisoning exposure cases. It offers one of the few real-time surveillance systems in existence, provides useful data, and is a model for public health surveillance.
-
evolution of Poison Control Centers in california
American Journal of Health-system Pharmacy, 2007Co-Authors: Judith A Alsop, Stuart E Heard, Timothy E AlbertsonAbstract:Poison Control Centers (PCCs) in California have faced substantial challenges in their effort to stay open and provide vital care for the state’s residents. The number of state PCCs decreased from 20 in the 1970s to 7 in the 1980s as regulations and operation costs increased,[1][1] and in 1989,
-
2006 annual report of the american association of Poison Control Centers national Poison data system npds
Clinical Toxicology, 2007Co-Authors: Alvin C Bronstein, Daniel A Spyker, Louis R Cantilena, Jody L Green, Barry H Rumack, Stuart E HeardAbstract:AbstractBackground: The American Association of Poison Control Centers (AAPCC; http://www.aapcc.org ) maintains the National Poison Data System (NPDS). Today, 60 of the nation's 61 US Poison Centers upload case data automatically. Most upload every 1- 60 minutes (median 11 minutes) to NPDS creating a real-time national exposure database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Fatalities were reviewed by a team of 27 medical and clinical toxicologists and assigned to 1 of 6 categories according to Relative Contribution to Fatality (RCF).Results: Over 4 million calls were captured by NPDS in 2006: 2,403,539 human exposure calls, 1,488,993 information requests, and 128,353 nonhuman exposure calls Substances involved most frequently in all human exposures were analgesics. The most common exposures in children less than age 6 were co...
-
the costs and outcomes of restricting public access to Poison Control Centers results from a natural experiment
Medical Care, 1998Co-Authors: Kathryn A Phillips, Stuart E Heard, Thomas E Kearney, Rick K Homan, Harold S Luft, Patricia Hiatt, Kent R OlsonAbstract:OBJECTIVES: The authors examined the costs and outcomes resulting from a natural experiment during which direct public access to Poison Control Centers was restricted and then restored. METHODS: Both societal and health care purchaser perspectives were used. Probability data were obtained from a natural experiment during which public callers from a large county in California were electronically blocked from directly accessing the Poison Control center. Callers were referred to 911, which had direct access to the Poison Control center, if they thought they had a Poisoning emergency. We conducted telephone interviews of: (a) persons who attempted to call the Poison Control center for a child's Poisoning exposure but who did not have direct access (n = 270) and (b) persons who called the Poison Control center after direct access was restored (n = 279). Cost data were obtained from primary data collection and from other sources. The outcome measure was the appropriateness of the treatment location (at home or at a health care facility). Caller-reported outcomes were also examined. RESULTS: The average additional cost per blocked call was $10.89 from a societal perspective, or $33.14 from a health care purchaser perspective. Fourteen percent of callers with restricted access were treated at an inappropriate location, compared with only 2% of callers with direct Poison Control center access. Also, 14% did not obtain any professional advice after they attempted to call the Poison Control center, although 66% of these cases involved potentially toxic substances. Results were robust across a range of sensitivity analyses. CONCLUSION: Restricting direct public access to Poison Control Centers created additional costs to society, the health care sector, and callers.
Henry A Spiller - One of the best experts on this subject based on the ideXlab platform.
-
suicide related over the counter analgesic exposures reported to united states Poison Control Centers 2000 2018
Pharmacoepidemiology and Drug Safety, 2020Co-Authors: Henry A Spiller, Gary A Smith, Alexandra G Hopkins, Sandhya Kistamgari, Nichole L Michaels, Alexandra R FunkAbstract:PURPOSE To investigate suicide-related over-the-counter (OTC) analgesic medication exposures among individuals ≥6 years old reported to United States (US) Poison Control Centers. METHODS Data from the National Poison Data System for the years 2000-2018 were retrospectively analyzed. RESULTS From 2000 to 2018, US Poison Control Centers recorded 549 807 suicide-related cases involving OTC analgesics, including 327 781 cases (59.6%) admitted to the hospital and 1745 deaths (0.3%). Most cases involved a single substance (67.5%) and occurred among females (72.7%) and individuals 6-19 years old (49.7%). Overall, the rate of exposures increased significantly by 33.5% from 2000 to 2018, primarily driven by the increasing exposure rate among 6- to 19-year-old females. From 2000 to 2018, exposure rates for acetaminophen and ibuprofen increased, while that for acetylsalicylic acid decreased. Additionally, the proportion of cases resulting in a serious medical outcome or healthcare facility admission increased for all types of OTC analgesics. Acetaminophen and acetylsalicylic acid accounted for 48.0% and 18.5% of cases, respectively, and 64.5% and 32.6% of deaths, respectively. Both acetaminophen and acetylsalicylic acid had greater odds of healthcare facility admission (ORs 2.56 and 2.63, respectively) and serious medical outcomes (ORs 2.54 and 4.90, respectively) compared with ibuprofen. CONCLUSIONS The rate of suicide-related OTC analgesic cases is increasing. Acetaminophen and acetylsalicylic acid cases are associated with greater morbidity and mortality. Prevention efforts should include implementing unit-dose packaging requirements and restrictions on package sizes and purchase quantities for acetaminophen and acetylsalicylic acid products to reduce access to large quantities of these analgesics.
-
ocular exposures reported to united states Poison Control Centers
Ophthalmic Epidemiology, 2019Co-Authors: Alisha Kamboj, Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Gary A SmithAbstract:Purpose: To investigate the epidemiology of ocular exposures reported to Poison Control Centers in the United States.Methods: A retrospective analysis of ocular exposures from 2000 to 2016 was cond...
-
kratom exposures reported to united states Poison Control Centers 2011 2017
Clinical Toxicology, 2019Co-Authors: Sara Post, Henry A Spiller, Thitphalak Chounthirath, Gary A SmithAbstract:AbstractContext: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety.Methods: This study analyzes exposures to kratom reported to Poison Control Centers (PCCs) in the United States during 2011–2017 from the National Poison Data System (NPDS).Discussion: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016–2017. Most exposures occurred among adults ≥20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21–3.55) and a serious medical outcome (OR: 2.25; 9...
-
antidepressant and antipsychotic medication errors reported to united states Poison Control Centers
Pharmacoepidemiology and Drug Safety, 2018Co-Authors: Alisha Kamboj, Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Nichole L HodgesAbstract:PURPOSE: To investigate unintentional therapeutic medication errors associated with antidepressant and antipsychotic medications in the United States and expand current knowledge on the types of errors commonly associated with these medications. METHODS: A retrospective analysis of non-health care facility unintentional therapeutic errors associated with antidepressant and antipsychotic medications was conducted using data from the National Poison Data System. RESULTS: From 2000 to 2012, Poison Control Centers received 207 670 calls reporting unintentional therapeutic errors associated with antidepressant or antipsychotic medications that occurred outside of a health care facility, averaging 15 975 errors annually. The rate of antidepressant-related errors increased by 50.6% from 2000 to 2004, decreased by 6.5% from 2004 to 2006, and then increased 13.0% from 2006 to 2012. The rate of errors related to antipsychotic medications increased by 99.7% from 2000 to 2004 and then increased by 8.8% from 2004 to 2012. Overall, 70.1% of reported errors occurred among adults, and 59.3% were among females. The medications most frequently associated with errors were selective serotonin reuptake inhibitors (30.3%), atypical antipsychotics (24.1%), and other types of antidepressants (21.5%). Most medication errors took place when an individual inadvertently took or was given a medication twice (41.0%), inadvertently took someone else's medication (15.6%), or took the wrong medication (15.6%). CONCLUSIONS: This study provides a comprehensive overview of non-health care facility unintentional therapeutic errors associated with antidepressant and antipsychotic medications. The frequency and rate of these errors increased significantly from 2000 to 2012. Given that use of these medications is increasing in the US, this study provides important information about the epidemiology of the associated medication errors.
-
buprenorphine exposures among children and adolescents reported to us Poison Control Centers
Pediatrics, 2018Co-Authors: Henry A Spiller, Marcel J Casavant, Thitphalak Chounthirath, Gary A Smith, Sara PostAbstract:OBJECTIVE: To investigate buprenorphine exposures among children and adolescents ≤19 years old in the United States. METHODS: Data were analyzed from calls to US Poison Control Centers for 2007–2016 from the National Poison Data System. RESULTS: From 2007 to 2016, there were 11 275 children and adolescents ≤19 years old exposed to buprenorphine reported to US Poison Control Centers. Most exposures were among children CONCLUSIONS: Buprenorphine is important for the treatment of opioid use disorder, but pediatric exposure can result in serious adverse outcomes. Manufacturers should use unit-dose packaging for all buprenorphine products to help prevent unintentional exposure among young children. Health providers should inform caregivers of young children about the dangers of buprenorphine exposure and provide instructions on proper medication storage and disposal. Adolescents should receive information regarding the risks of substance abuse and misuse. Suspected suicide accounted for 12% of adolescent exposures, highlighting the need for access to mental health services for this age group.
