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The Unexpected Dangers in Your Medicine Cabinet

October 24th, 2014

by Josh Knoebel, PharmD Candidate

Your doctor prescribes medications to help you control the pain you are feeling. The drugs do their job, and the pain gradually stops. This doesn’t prevent you from keeping the medicine though; after all, it was expensive, and who knows when you may need it again? This is a common scenario in many households, and a recent study published in Pediatrics: The Official Journal of the American Academy of Pediatrics confirms a concern many health professionals share regarding household medication management. The common opinion is to keep medication up and out of sight of children, but is that enough? As parents know far too well, children are not limited to what they can reach from the floor. If they see mommy put that “candy” in the cabinet, they may just try to climb onto the counter and get it themselves. The Center for Disease Control and Prevention (CDC) claims that more than 1.4 million emergency department visits were related to pharmaceuticals in 2011, and of the 41,340 drug overdose deaths in the United States, 22,810 (55%) were related to pharmaceuticals.1 Over 60,000 of these emergency department visits were for children six years or younger, and over 500,000 calls were made to poison control centers concerning these youngsters.2

Twelve specific active ingredients were found by the Pediatrics study that caused nearly half of the poisonings in the United States.2 Opioids (17.6%) and benzodiazepines (10.1%) top the chart as the classes of drugs with the highest number of poisonings. The twelve most common active ingredients of poisoning cases in children age six and under are listed in order of decreasing incidence:

  1. Buprenorphine (734 cases)
  2. Clonidine (701 cases)
  3. Glipizide (386 cases)
  4. Clonazepam (368 cases)
  5. Metoprolol (314 cases)
  6. Lorazepam (309 cases)
  7. Lisinopril (298 cases)
  8. Amlodipine (295 cases)
  9. Bupropion (265 cases)
  10. Glyburide (257 cases)
  11. Hydrocodone (252 cases)
  12. Oxycodone (249 cases)

The number of medication poisonings has continued to rise from 2004 to now3, a trend that is certainly reversible with diligence.

There are measures you can take to keep not only small children, but teenagers and adults alike safe from accidental medication poisoning. The first step is to make sure that all medications are kept in child-safe containers. Daily pill containers are convenient to remember medication use, but are often not child proof. Second, properly dispose of any and all out dated medications. Disposal of medications in the trash is not advised as they are still accessible to a curious child, or even the family pet. Contact your local pharmacist and ask about take back programs in your community.4 If there are no medication disposal programs available, there are three steps endorsed by the FDA for disposal in household trash. First, remove the medication from its original packaging and scratch out any personal information. This helps to protect your identity and sensitive health information. Second, make the medications unusable by mixing with inedible materials such as kitty litter, old coffee grounds, or sand. Lastly, put the mixture into sealable containers to prevent medication from falling out of the trash can.4

The most important change in preventing medication poisonings is to take your medications out of the medicine cabinet and keep them in a secure location. The best options are a lock box or a combination safe in a low traffic area of the house such as the bedroom closet. Ironically, the bathroom medicine cabinet is one of the least effective places to keep medications. Not only is it easy to access for children, but humidity from the bath or shower can damage the medications.5

What other preventative methods do you use with your medicine? Leave a comment below and let us know how you keep your medications secure!

References

  1. Paulozzi LJ. Prescription drug overdoses: a review. Journal of Safety Research. 2012;43(4): 283-289.
  2. Substance Abuse and Mental Health Services Administration. Highlights of the 2011 drug abuse warning network (DAWN) findings on drug-related emergency department visits. Substance Abuse and Mental Health Services Administration. http://www.samhsa.gov/data/sites/default/files /DAWN127/DAWN127/sr127-DAWN-highlights.pdf. Posted February 22, 2013. Accessed September 29, 2014.
  3. Lovegrove MC, Mathew J, Hampp C, Governale L, Wysowski DK, Budnitz DS. Emergency hospitalizations for unsupervised prescription medication ingestions by young children. Pediatrics. 2014;134(4): e1009-1016.
  4. Office of the Commissioner. Consumer updates – how to dispose of unused medicines. U.S. Food and Drug Administration. http://www.fda.gov/ForConsumers/ConsumerUpdates /ucm101653.htm. Posted December 24 2013. Updated May 19 2014. Accessed October 13 2014.
  5. Dugdale DC, Zieve D. Storing medication safely. Medline Plus. http://www.nlm.nih.gov /medlineplus/ency/article/007189.htm Updated 3/26/2011. Accessed 10/22/2014.

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4 Responses to “The Unexpected Dangers in Your Medicine Cabinet”

  1. Laura Farleman Says:

    Thanks for your blog post Josh. I think it’s very important to know how to properly dispose of medications. I knew about disposing of medications at a disposal facility and mixing medicines with inedible materials, but I had not thought to scratch off my personal information from the prescription bottle.

    Freshman year I helped conduct a study looking at patient knowledge regarding proper medication disposal in the local, Greene county community. It was surprising to learn that most people believe they know how to properly dispose of medication, however what they believed was the correct way, is actually not recommended anymore. Most people we surveyed thought it was right to throw medications in the trash, as you mentioned in your blog. However, as your blog mentions, this is typically not the best way to dispose of these medications.

    I think it’s critical to know how to best dispose of each medication. Often times I have looked at the medication information insert to check on the proper disposal means for each specific medication. However, it’s important to note that some medications should be completed, such as an antibiotics (look at the prescription bottle, and if there is a sticker saying to finish the medication, be sure to do so, as it is important to helping with the causes of the sickness. Great information Josh, very informative!

  2. Mouhannad Saad Says:

    Thanks Josh for this helpful information. I personally try not to keep medications that I don’t use at home. I try to dispose the old medications as it can get in my kids hands and I don’t want to risk it any time. I keep my medications in a high cabinet or somewhere out of children reach. Also I usually keep it somewhere where it is secured and not easy for a child to open.
    My question is that you said that children poisoning incidents are increasing and trend is rising since 2004, why is it since 2004 and what is the reason for this rise, even though the government put many plans to reduce these incidents, so why do we still see this rise in trend?

    Thanks again Josh

  3. Josh Knoebel Says:

    Mou, I believe the rise is connected to our society’s increasing utilization of medications in general. As more and more people are prescribed these powerful drugs (thinking especially of the baby boomers who are now in the prime age range for heavy medication therapy), more and more children find access to medications.

    Laura, good point about checking the inserts. Many medications are actually disposable by flushing down the toilet. The FDA provides a list here: http://goo.gl/M7LU6g

  4. Kaysie Brittenham Says:

    This was a really interesting blog post to read. I think it discusses a huge problem that is largely overlooked. Prior to reading this post, I had no idea how to properly dispose of medications other than through take back programs. I was unaware that you were supposed to mix medications with inedible materials when discarding them. I think this is definitely a very beneficial recommendation and that it makes a lot of sense. Also, I was surprised by the prevalence of drug poisonings.

    I think this is an issue that pharmacists can play a huge role in combating. Talking through proper medication disposal with patients could be highly beneficial. Pharmacists could easily address this issue with patients when they have their prescriptions filled.

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