The Increasing Risk of Unintentional Poisoning

Unintentional poisoning is a cause of death with a quiet prevalence. The suspected role of unintentional poisoning in celebrity deaths has garnered headlines that span several decades, from Elvis Presley to Heath Ledger. What is less publicized is the effect unintentional poisoning has on the general population. Today, the odds an accidental death was caused by unintentional poisoning are an alarming 1 in 6.07, a statistic that has tripled since 1990.

In just seven years, the odds a person will die from unintentional poisoning in a year have increased from1 in 22,900 in 1999 to 1 in 10,870 in 2006. Rates were highest among middle-aged adults, but rates for teenagers and young adults weren’t far behind. New Mexico has the highest unintentional poisoning rates (1 in 6,691), while Maryland has the lowest (1 in 99,020). The majority of these poisonings are caused by illegal and prescription drugs. In 2004, 95% of accidental poisoning deaths were caused by drugs, most commonly cocaine, heroin, and opioid pain medications (i.e. Oxycontin® and morphine).

Patterns in unintentional poisoning deaths have evolved over the last 20 years. Toxicologists have found that while people were more likely to overdose on just 1 drug 20 years ago, more people today are dying from mixing substances. Dr. Jeffrey Jentzen, the president of the National Association of Medical Examiners, said in an interview with Yahoo!, “Twenty years ago we’d have to look for alcohol and one other drug and now we typically have to do five to seven drugs.”

As people in the U.S. grow older, the number of medications they take for chronic illnesses and health conditions increases, which puts a large number of people at risk for poisoning. And the Food and Drug Administration has recently expressed concern that some consumers, including children, are unknowingly ingesting acetaminophen—the active ingredient in Tylenol®—in unsafe doses because the same drug is found in a variety of other products used for common ailments like colds and flu, and plain-old aches and pains. According to the New York Times, approximately 400 people die and 42,000 are hospitalized from acetaminophen poisonings each year.

McNeil Consumer Healthcare, the producer and distributor of Tylenol®, responded to the recent concerns over acetaminophen in a letter to healthcare professionals dated July 1, 2009. In it, McNeil recommends the use of acetaminophen over nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin and ibuprofen, with the statement “As the FDA stated in its own assessment, the risk of liver injury with acetaminophen is related to overdose, whereas risks associated with NSAIDS, such as gastrointestinal bleeding and renal injury, occur at recommended doses.” In addition, the McNeil letter suggests healthcare professionals encourage appropriate use of acetaminophen in order to avoid any adverse effects.

Increases in poisonings have not come without a cost. In 2000, they totaled $26 billion in medical expenses, and accounted for 6% of all the economic costs for injuries in the U.S. Of these cases, 75%—$19 billion worth—involved males, while 25%—$7 billion worth—involved females.

The New York City Medical Examiner’s Office ruled that Heath Ledger, 29, who died in January, 2008, succumbed to an “an accidental overdose of prescription medications”—including strong painkillers, anti-anxiety medications and sleeping pills. What didn’t make headlines was the fact that more than 27,500 other people met a similar end.

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