As attention-deficit/hyperactivity disorder (ADHD) diagnoses have risen, so have calls to poison control centers for youths taking their medications incorrectly.
A new study found an almost 300% increase in errors related to ADHD medications reported to U.S. poison control centers over the past two decades.
More than 3 million children are estimated to have a prescription for an ADHD medication, most commonly stimulants, according to “Pediatric ADHD Medication Errors Reported to United States Poison Centers, 2000-2021” (DeCoster MM, et al. Pediatrics. Sept. 18, 2023).
Researchers from Nationwide Children’s Hospital in Columbus, Ohio, set out to look at trends in calls to poison control centers for incidents involving ADHD medication errors. Among children and teens under 20 years, there were 124,383 such incidents from 2000 through 2021. The number increased 299% from 1,906 in 2000 to 7,603 in 2021, according to the study.
“The increase in the reported number of medication errors is consistent with the findings of other studies reporting an increase in the diagnosis of ADHD among U.S. children during the past two decades, which is likely associated with an increase in the use of ADHD medications,” co-author Natalie Rine, Pharm.D., director of the Central Ohio Poison Center at Nationwide Children’s Hospital, said in a press release.
Some of those incidents involved multiple substances, and ADHD medications may not have been the main source of health issues. Among 87,691 incidents in which ADHD medications were deemed responsible for health impacts, 67% involved children ages 6-12 years and 76% were among males. Most occurred at home.
About half of the incidents involved amphetamines and related compounds, 23% involved guanfacine and 15% involved methylphenidate.
Just over half of the incidents occurred when someone inadvertently took medication twice, about 13% took someone else’s medication and about 13% took the wrong medication.
About 83% of youths did not see a health care provider for treatment, 4% had a serious medical outcome and 2% were admitted to a health care facility.
Those involving guanfacine were more likely to be associated with a serious medical outcome compared to those involving amphetamines or related compounds. Children under 6 years were more likely to have a serious outcome than older children.
“Because ADHD medication errors are preventable, more attention should be given to patient and caregiver education and development of improved child-resistant medication dispensing and tracking systems,” senior author Gary A. Smith, M.D., Dr.P.H., FAAP, a member of the AAP Council on Injury, Violence and Poison Prevention and director of the Center for Injury Research and Policy at Nationwide Children’s Hospital, said in a press release. “Another strategy may be a transition from pill bottles to unit-dose packaging, like blister packs, which may aid in remembering whether a medication has already been taken or given.”
- AAP Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.
- ADHD medication guide from Cohen Children’s Medical Center
- Information for parents from HealthyChildren.org on ADHD
- Information from the Centers for Disease Control and Prevention on ADHD