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Pediatrics specialist weighs in on a 300% increase in ADHD medication user error

Photo: Pixabay
Photo: Pixabay

A study reports poison control saw a huge increase in ADHD medication user error over the past 22 years. An Orlando pediatrics specialist shifts her attention to explanations and solutions.

Between 2000 and 2021, U.S. poison control centers across the nation reported a 300% increase in calls regarding children improperly taking ADHD medication outside of hospital settings, according to a study by the American Academy of Pediatrics.

"Thinking about the use of these medications, it kind of makes sense," said Dr. Lisa Spector, division chief for the Division of Developmental Behavioral Pediatrics at Nemours Children's Hospital in Orlando.

"There's been a dramatic increase in the incidence and prevalence of children being diagnosed with ADHD over the past couple of decades," Spector said.

And with more ADHD patients relying on medication, comes more mistakes, she said.

According to the Centers for Disease Control and Prevention, about 6.4 million children were diagnosed with attention-deficit/hyperactivity disorder between 2003 and 2011.

In the most recent collection of data within a four-year period, 2016 to 2019, 6 million children were diagnosed — suggesting the rate of diagnoses has increased dramatically.

 Data provided by the National Survey of Children's Health.
Centers for Disease Control and Prevention
Data provided by the National Survey of Children's Health.

In 2012, 65% of Florida parents with ADHD-diagnosed children reported their child was on medication. That's ahead of the national figure, which was 62%.

The AAP study noted poison control centers saw most ADHD calls involved children ages 6 to 12 — about 76% of which were boys. Most cases did not require hospital treatment. However, children 6 and younger were far more likely to experience a serious medical outcome.

Reasons and consequences of medication errors

Spector has heard parents with ADHD children "experiment" by giving one nonprescribed child the medication from a prescribed sibling. That’s inadvisable, Spector said.

“If somebody has a preexisting structural heart defect, the medications can lead to additional cardiac complications; and in some instances, however, rare, sudden cardiac death,” Spector said.

One such cardiac complication would include arrhythmia, but death is a possibility only in the most extreme of cases. In the AAP's study, no deaths were listed, but 4.2% (3,561 cases) did suffer a serious medical episode.

AAP cited that most cases involved patients accidentally taking a second pill, forgetting they took the first. Because of the nature of ADHD, Spector can see how that might easily happen.

"ADHD is highly inheritable, meaning that oftentimes other family members also have ADHD," she said. "I can see and envision a situation where one parent thinks somebody gave their child medication or didn't give the medication, and the other parent thinks that their (spouse) didn't give them a medication, and the child receives it twice."

It's OK to receive double the amount of ADHD medication in most instances since the next step for patients unhappy with their meds would be to double the dosage. Still, parents should enforce scheduling a time to take meds to avoid complications.

By the numbers

These were the most common reasons for medication errors:

  • 54% – Inadvertently taken or given medication twice
  • 13% – Inadvertently taken or given someone else’s medication
  • 13% – Wrong medication taken or given

How to avoid errors

Doctors recommend parents keep children on a timely schedule when taking ADHD medication.

Plus, Spector advises keeping medication out of reach from young hands.

"Having medication locked up, making sure that we're supervising the administration and the containment of those medications is important," Spector said.

Copyright 2023 WMFE. To see more, visit WMFE.

Joe Mario Pedersen