David Baxter PhD
Late Founder
Some child cough medicine overdoses linked to abuse
CBC News
Friday, December 19, 2008
Some children in the U.S. who died after taking over-the-counter cough medicines may have been given the medication to sedate them, say experts who reviewed the deaths.
Writing in the December issue of the Annals of Emergency Medicine, Dr. Richard Dart, director of the Rocky Mountain Poison and Drug Center in Denver, and his colleagues alleged that in 26 of 79 cases where an adult gave the medication, there was "non-therapeutic intent."
"In the cases of non-therapeutic intent, circumstances involved attempts at sedation and several included apparent attempts of overt child abuse and were under investigation by law enforcement authorities," the researchers wrote.
The panel of eight experts in pediatrics, toxicology and forensic pathology all had to agree that the intent was clear.
"They were quite certain in all the cases they decided were intentional," Dart said.
Of 103 cases associated with non-prescription drugs, the evidence suggested an overdose in 88 cases, and the dose could not be assessed in the remaining 15 cases.
Label changes recommended
Cough and cold medications are not intended to sedate children, but in many cases caregivers admitted that was their intent, the researchers said.
"It is important to understand that many of the cases in which the intent was to produce sedation occurred outside the child's normal bedtime," they wrote.
"In other words, these were not attempts to facilitate sleep by reducing nighttime distress caused by cough and cold symptoms. To minimize deaths that result from similar attempts, nonprescription labels should clearly advise against the use of these products for sedation."
On Thursday, Health Canada advised that children under six years of age shouldn't be given cough and cold medications, given the number of adverse reactions that have been reported since 1995.
Previously, the department warned parents about giving the medications to children under the age of two.
In October, drugmakers in the U.S. changed the labels on cough and cold medications to warn against their use in children younger than four, given complications from accidental misuse. The U.S. Food and Drug Administration is considering requests to ban the use of the drugs in children under 12.
"We aren't trying to say there aren't accidents," Dart said. "I am concerned that we have blinders on and we don't want to admit that there is a group of parents who all the warnings in the world won't help because they did it knowingly."
The researchers also identified these contributing factors:
The research was supported by funding from McNeil Consumer Healthcare, which makes over-the-counter cold medicines.
CBC News
Friday, December 19, 2008
Some children in the U.S. who died after taking over-the-counter cough medicines may have been given the medication to sedate them, say experts who reviewed the deaths.
Writing in the December issue of the Annals of Emergency Medicine, Dr. Richard Dart, director of the Rocky Mountain Poison and Drug Center in Denver, and his colleagues alleged that in 26 of 79 cases where an adult gave the medication, there was "non-therapeutic intent."
"In the cases of non-therapeutic intent, circumstances involved attempts at sedation and several included apparent attempts of overt child abuse and were under investigation by law enforcement authorities," the researchers wrote.
The panel of eight experts in pediatrics, toxicology and forensic pathology all had to agree that the intent was clear.
"They were quite certain in all the cases they decided were intentional," Dart said.
Of 103 cases associated with non-prescription drugs, the evidence suggested an overdose in 88 cases, and the dose could not be assessed in the remaining 15 cases.
Label changes recommended
Cough and cold medications are not intended to sedate children, but in many cases caregivers admitted that was their intent, the researchers said.
"It is important to understand that many of the cases in which the intent was to produce sedation occurred outside the child's normal bedtime," they wrote.
"In other words, these were not attempts to facilitate sleep by reducing nighttime distress caused by cough and cold symptoms. To minimize deaths that result from similar attempts, nonprescription labels should clearly advise against the use of these products for sedation."
On Thursday, Health Canada advised that children under six years of age shouldn't be given cough and cold medications, given the number of adverse reactions that have been reported since 1995.
Previously, the department warned parents about giving the medications to children under the age of two.
In October, drugmakers in the U.S. changed the labels on cough and cold medications to warn against their use in children younger than four, given complications from accidental misuse. The U.S. Food and Drug Administration is considering requests to ban the use of the drugs in children under 12.
"We aren't trying to say there aren't accidents," Dart said. "I am concerned that we have blinders on and we don't want to admit that there is a group of parents who all the warnings in the world won't help because they did it knowingly."
The researchers also identified these contributing factors:
- Age younger than two years.
- Use of the medication for sedation.
- Use in a daycare setting.
- Use of two medicines with the same ingredient.
- Failure to use a measuring device.
- Product mis-identification.
- Use of a non-prescription drug intended for adult use.
The research was supported by funding from McNeil Consumer Healthcare, which makes over-the-counter cold medicines.
