Therapeutic errors are becoming more common, and deliberate self-exposure rates increase sharply at around age 12, particularly in girls.
Latest US and Australian statistics highlight both accidental and deliberate poisoning in children and adolescents as an ongoing public health burden.
Over 1.5 million substance exposures were reported in US children aged six-12 years between 2000 and 2023.
Exposures increased by 54% over the 23-year period, but the rate associated with suspected self-harm or suicidal intent rose by more than 300%.
Attempted suicide or self-harm accounted for less than 5% of these exposures overall. However, in 12-year-olds specifically, more than a quarter of exposures were suspected to involve self-harm or suicidal intent.
The NSW Poisons Information Centre, which covers NSW, Tasmania and the ACT, received almost 9000 calls relating to exposures for children aged five to 14 years in 2024 alone.
“Of these calls, just over 40% were accidental, 36% were therapeutic errors and 16% were deliberate self-poisonings,” a spokesperson told The Medical Republic.
They said most of those deliberate self-poisonings were in children, with 12–14-year-olds accounting for 93%. Nearly 90% were girls.
A study earlier this year also found a marked increase in Australian child and adolescent female self-poisonings between 2018 and 2023. Increases were strongly associated with covid restrictions but persisted after they ceased.
Of the self-poisoning calls across all of Australia’s poisons information centres over the six-year period, nearly 20,000 were for children aged five-14 and more than 44,000 were for adolescents aged 15-19 years.
A recent Victoria Coronial report highlighted that suicide by overdose was proportionally higher among females (over 30%) than males (13%), and that three quarters of overdose deaths were unintentional.
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Pharmaceutical drugs were involved in the majority of these cases, although their proportion declined gradually in Victoria from 78% in 2015 to less than 70% in 2024.
Diazepam and pregabalin were among the top five contributing drugs in 2024.
According to the Australian Institute of Health and Welfare, accidental poisoning is the ninth leading cause of injury hospitalisations, most of which are due to pharmaceutical substances, and the fifth leading cause of injury deaths.
Although the overall number of deaths due to accidental poisoning has generally increased over time, fewer were recorded in the 2022-2023 financial year compared with the previous year (1400 vs 1570).
These statistics came with the caveat that intent was often difficult to ascertain in poisoning cases, so a substantial number of hospitalisations and deaths had to be categorised as undetermined intent.
More than half of the US exposures 2000-2023 were attributed to therapeutic errors such as incorrect medication, dosage or timing.
“GPs are reminded to practice safe prescribing practices and to speak to patients and parents about safe storage of medicines to prevent deliberate exposures along with accidental and therapeutic errors,” the NSW PIC spokesperson said.
The NSW PIC can help GPs with risk assessment regarding exposure to medicines, recreational substances and chemicals. Call 13 11 26.
