Rethinking Child-Proof Packaging: Can Manufacturers Do More to Stem Pediatric Poisoning?

A newly published article in the Journal of Pediatrics calls attention to the increasing numbers of children who are poisoned each year by accidentally ingesting medication not intended for them. More and more kids, the authors find, are winding up in emergency rooms after accidentally taking pills prescribed for their older siblings, parents, grandparents, and others. Statistics show that, since 2005, there have been more ER visits by young children (5 and under) due to prescription drug poisoning than due to motor vehicle crashes. Other indicators--such as calls to poison control centers--also point to a growing problem.

Part of the increase can be correlated to the greater prevalence of prescription drugs in households in general—particularly opioid analgesics, sedative-hypnotics, and cardiovascular medications, the article says. The severity of poisoning is also exacerbated by the increase in controlled-release medications, which tend to carry higher dosages per tablet, capsule or other means of delivery.

Consumer education efforts, which have had some success in the past, the authors note, are simply not enough to solve the problem. Manufacturers and packagers must also get involved to improve “child-proof” bottles, increase the prevalence of blister packs, and improve packaging for the elderly that is often too accessible to children. The authors urge “a shift in attention to packaging design changes that reduce the quantity a child could quickly and easily access in a self-ingestion episode.”

They conclude: “The problem of pediatric medication poisoning is getting worse, not better. Past preventive efforts have proved to be inadequate . . . Educational efforts are important but are unlikely to make a significant improvement alone. Education interventions should readdress home storage of all medications, repackaging of medications—particularly grandparents’ medications in ‘‘pill minders,’’ and the fact that older siblings may not be as careful as parents when opening containers or taking medications. Storage devices and child-resistant closures may need to improve. Additionally, mechanical barriers to ingestion such as blister packs may be required for more substances. Preventive efforts should also address appropriate prescribing and society’s problem with opioid and sedative abuse.”

In other words, education efforts must be aimed at drug manufacturers as well.

--Paul Thomas

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