TW: Substance misuse, suicide, bullying
Across all age groups, poison control centers are fielding an increasing number of calls that are severe and may lead to harm or death, according to a study by UVA researchers that looked at national data from 2007 to 2021.
Some calls are related to drugs that have recently been decriminalized in areas like the nation’s capital, Washington, D.C., which naturally spills over into Virginia.
Suicide attempts, illegal drug use and misuse of medications to get high, known as intentional exposures, accounted for a 233 percent rise in calls that resulted in death among adults.
Incorrect dosing, exposure to harmful substances through work or the environment, bites, stings and food poisoning, known as unintentional exposures, in adults also increased with the number resulting in death climbing by 65 percent.
In children, the number of pediatric cases for both intentional and unintentional exposure are also on the rise.
Christopher Holstege, MD, the director of the UVA Health Blue Ridge Poison Center and a professor with the UVA School of Medicine, recently completed a study with colleagues that evaluated 33.7 million poison exposure calls reported to the 55 poison centers in the U.S. from 2007 to 2021.
Suicidal ideation, overdoses among youth
In his clinical practice at the University of Virginia, Holstege said, the number of intentional exposures including overdoses among youth is of particular concern. Overdoses of acetaminophen (Tylenol), ibuprofen (Advil) and diphenhydramine (Benadryl) are something he sees regularly due to the drugs availability in large quantities without a prescription.
In Britain, Holstege said, drugs including acetaminophen are packaged in blister packs instead of oversized bottles. It helps, he said, because it slows down the process of an attempted suicide.
“I certainly have my concerns in regard to the pediatric population,” Holstege said. “We did a different study … where we showed a significant increase in pediatric suicides that occurred, especially escalating after the pandemic, and acetaminophen was one of the top agents because its readily available.”
Holstege said that COVID, its aftermath and social media are part of the reason he believes numbers are on the rise, especially among youth in Virginia and nationwide.
In January, Meta CEO Mark Zuckerberg apologized to parents attending a child safety Senate hearing who said social media contributed to their children’s suicides.
“I’m sorry for everything you’ve all gone through,” Zuckerberg said. “It’s terrible. No one should have to go through the things that your families have suffered.”
Suicide is the second leading cause of death among ages 10 to 24 in the United States, according to the Center for Disease Control.
“There’s a number of things that are coming out with a new generation,” Holstege said. “The mental health crisis is growing, and in my practice, and what we showed in our study, at increasingly younger ages than when I first started in practice here at the University of Virginia 25 years ago. I never saw 10- to 12-year-olds trying to commit suicide, and now I do.”
The American Academy of Pediatrics has recommended universal screening for suicide risk in all children 12 and older and when needed in children under 8.
The news is filled with cases that reinforce the need for a deeper focus on pediatric suicide.
Last month, in Indianapolis, a 10-year-old boy named Sammy died by suicide after he was allegedly bullied by classmates.
Flora, a 12-year-old girl living in Nevada, died by suicide after bullying at school and online as well as humiliation from other students.
Isabella, or “Izzy” as she was known, was 10 years old when she died by suicide in Utah, something her mom attributes in part to bullying.
And in Virginia, a Yorktown boy who was 12 years old allegedly died by suicide, again after bullying.
Beyond clinical treatment
At UVA, Holstege said, they are looking at what can be done to promote overall well-being: engaging with the arts or music, good nutrition, exercise and getting outdoors.
“We have a generation that is outdoors less than ever. I think as we look at our schools, as we look at society as a whole, we have to start to look at what initiatives do we want to do to really try to mitigate the mental health crisis that is occurring in our youth,” Holstege said.
“It’s a challenging time, and we have to really look at this from the mental health crisis and how we’re going to try to mitigate the substance use crisis that’s out there right now too.”
Decriminalization, availability, opioids
The number of unintentional exposures in the last four or five years due to cannabis and marijuana edibles is up, in large part due to the availability and decriminalization in some places, and many resemble popular candy or cereal. They are also seeing more calls about hallucinogenic agents such as magic mushrooms and Molly.
As a nation, we are also continuing to see a significant opioid crisis, Holstege said.
Finding answers on the Internet; potential for a ‘detrimental outcome’
While the outcomes are proving more deadly, the number of calls actually coming to poison centers is down, with some people turning to the internet to find answers.
“The calls to poison centers have decreased, and part of that is because people are searching themselves on search engines on the internet,” Holstege said. “There’s a danger to that too, because some of those searches aren’t necessarily accurate.
“The complexity of the cases, just because of the various drugs that are out there, are escalating substance use, misuse, opioid epidemic, the mental health crisis with suicide attempts … I think we’re seeing a continuation of increased complex calls to poison centers and certainly engagement by emergency departments across the state.”
Holstege said that instead of relying on the internet, he encourages people to call a poison center.
“We’re dedicated to our Virginia citizens,” Holstege said. “We will help to facilitate, if that’s going to the hospital, we’ll call the hospitals and let them know they are coming in, so that the hospital will be prepared when they come in.
“It’s free. It’s confidential. I certainly don’t like for someone to sit at home wondering if they should call or to try to search for themselves.”
He said they can also help people save money by telling them to stay home when a hospital visit isn’t necessary – potentially saving the person money.
“We’re a confidential resource. We have experts who are used to these calls. We can help guide care, but we can also tell you when it’s safe to stay home,” he said.
“I worry about the public … if they don’t do an appropriate search, you know. We’ve found that about a lot of medical things, but if they make the wrong call based on a Google search about whether or not I should go with my child, I’d hate to have a detrimental outcome.”
About the Blue Ridge Poison Center
The Blue Ridge Poison Center is a 24-hour, 7 days a week hotline for help with suspected poisonings. They also answer non-emergency calls about poisons and food safety. Help is confidential and free.
Call (800) 222-1222.
Call right away if you think someone:
- Swallowed something harmful
- Touched or breathed a dangerous fume or gas
- Overdosed on any substance
- Was bitten or stung by a snake, spider, etc.
If you or someone you know needs support now, call or text 988 or chat at 988lifeline.org
For local mental health resources, visit AFP’s Project Mental Health page.
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Crystal Graham
