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Goals
After completing this article, readers should be able to:
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Explain the national trends in suicidal ingestion and recreational abuse among adolescents.
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Familiarize yourself with ingestions of prescription drugs, over-the-counter medications, and recreational drugs of abuse.
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Describe the potential serious clinical complications and the treatment options for these ingestions.
introduction
Adolescents generally do not unintentionally ingest pharmaceutical agents, as seen in the younger pediatric population. The main reasons for ingestion by adolescents generally fall into 2 categories: suicidal / self-harm and recreational abuse. These 2 categories are very important and have different levels of morbidity and mortality. The agents ingested may be unique and require different clinical management and preventive strategies. Suicidal ingestion alone accounts for over a million emergency room visits annually, making it a very timely and important review article. (1)
Suicidal ingestions
Adolescent suicide and suicide attempts are on the rise and now represent more than 1.12 million emergency room visits per year. (1) The reasons are multifactorial, the ingestions being an integral part of a plan or of a suicide attempt. A recent study assessed national trends in suicidal ingestions over the past decade using the National Poison Center System, a database that includes all calls to poison control centers in the United States. (2) This study found that there were approximately 400,000 calls for “suspected intentional suicide”. More importantly, calls regarding adolescent ingestion accounted for over 80% of all intentional ingestion calls during the study period. The top 5 agents ingested included the over-the-counter (OTC) drugs acetaminophen, ibuprofen, and antihistamines, as well as prescription psychiatric drugs.
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