The American Association of Poison Control Centers (AAPCC) found that prescription drug poisonings are the leading cause of injury and death in the United States and that bath salts, synthetic marijuana (Spice) and laundry detergent pod poisonings are emerging threats to public health. The AAPCC paper was published online in Annals of Emergency Medicine.
Bath salts are drugs that have one or more man-made chemical related to cathinone. Cathinone is an amphetamine-like stimulant found naturally in the khat plant. Chemically, they are similar to other amphetamines such as methamphetamine and to MDMA (Ecstasy). Not to be confused with bathing products such as Epsom salt, “bath salts” is the street name used to evade police detection.
“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, M.D., Ph.D., of the Rocky Mountain Poison and Drug Center in Denver, Colorado.
“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 five, 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. Designer drugs such as bath salts (a type of amphetamine), synthetic marijuana (also known as Spice) 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,” Dart said. “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.”
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Written by Veronica McNamara, Sovereign Health Group writer