Pubdate: Fri, 23 Jul 2010 Source: Vancouver Sun (CN BC) Copyright: 2010 The Vancouver Sun Contact: http://www.canada.com/vancouversun/letters.html Website: http://www.canada.com/vancouversun/ Details: http://www.mapinc.org/media/477 Author: Laura Stone, Postmedia News STUDY FINDS 'MALICIOUS' DRUGGING OF KIDS Giving Unneeded Pharmaceuticals To Children Is An Under-recognized Form Of Abuse, Author Says "Malicious" use of pharmaceuticals on children is an under-recognized form of child abuse, a study released Thursday says. Researchers analyzed information from the U.S. National Poison Centre Data System from the past decade and found a small but steady number of young children, median age two, who were exposed to at least one sedating agent, including street drugs, antipsychotics, cough medicines and ethanol. "It's an aspect of child abuse that is not often considered," said Dr. Shan Yin, a pediatrician at the Cincinnati Children's Hospital and author of the study published in the Journal of Pediatrics. "I think this is going on, probably throughout the country, and we're not paying attention to it." The study looked at cases from 2000 to 2008, involving pharmaceutical exposure to children under seven years old, for which the reason was coded as "malicious" by poison centre standards. A total of 1,439 cases met the criteria, averaging 160 per year. There were 172 cases that resulted in "moderate or major" outcomes, such as coma, and 18 of them ended in death. The most commonly reported drug category was analgesics, which includes acetaminophen, ibuprofen and a combination of acetaminophen with other drugs. The second most common class of drugs was stimulants and street drugs, which included marijuana, cocaine and methamphetamine. Sedatives, hypnotics and antipsychotics, cold and cough medicines, ethanol, topical drugs such as antiseptics, laxatives and antihistamines were other common categories of drugs reported to the centre, the study found. A few cases involved antidepressants and cardiovascular drugs. "If even a fraction of the nearly 150,000 annual cases of physical abuse also involve an element of nontherapeutic pharmaceutical administration, then we are missing thousands of cases each year," the study says. "This study provides a starting point for estimating the true incidence of this potentially under-recognized problem." Although there is no Canadian research or statistics detailing pharmaceuticals in children, there is similar concern among physicians in Canada. "Typically, when the public thinks about child abuse, they think about physical abuse of a child, neglect, cruelty -- emotional and other. Indeed, people don't routinely think about giving a child a medication. But unfortunately, this is not rare," said Dr. Gideon Koren, a pediatrician at the Hospital for Sick Children in Toronto. Koren, who sees a couple of cases of abuse each month, said not all cases of pharmaceuticals can be categorized as "malicious." Parents sometimes use sedatives to calm their children down, while others involve ignorance or child mischief, he said. But he said in other cases, parents deliberately drug their kids to serve other forms of abuse, such as sexual abuse, he said. Another problem is that of resources for pediatricians. Toronto's Sick Kids, one of the world's foremost pediatric hospitals, has its own department for toxicology and sophisticated equipment, but most smaller hospitals do not have the means to test for pharmaceuticals, which can be difficult to diagnose, said Koren. Yin said he hopes the study and further research raises awareness among doctors to consider the issue of pharmaceutical abuse. - --- MAP posted-by: Jo-D