Malicious use of pharmaceuticals in children

To describe malicious administration of pharmaceutical agents to children.

We performed a retrospective study of all pharmaceutical exposures involving children <7 years old reported to the US National Poison Data System from 2000 to 2008 for which the reason for exposure was coded as "malicious."

A total of 1439 cases met inclusion criteria. The mean number of cases per year was 160 (range, 124 to 189) that showed an increase over time. The median (IQR) age was 2 (1.5) years. Outcome data were available for 1244 (86.4%) patients. Of these exposures, 172 resulted in moderate or major outcomes or death. 9.7% of cases involved >1 exposed substance. The most common reported major pharmaceutical categories were analgesics, stimulants/street drugs, sedatives/hypnotics/antipsychotics, cough and cold preparations, and ethanol. In 51% of cases there was an exposure to at least one sedating agent. There were 18 (1.2%) deaths. Of these, 17 (94%) were exposed to sedating agents, including antihistamines (8 cases) and opioids (8 cases).

Malicious administration of pharmaceuticals should be considered an important form of child abuse.