Nonprescription medication abuse underestimated

Nonprescription medications are just as likely a cause of poisoning as prescription drugs, according to a new study by Timothy Wiegand, M.D. from the University of Rochester Medical Center in the US and colleagues. Their work, which analyzes the data from the second annual report of the Toxicology Investigators Consortium (ToxIC), is published online in Springer's Journal of Medical Toxicology.

In 2010, the American College of Medical Toxicology established its case registry, ToxIC, which acts as a real-time surveillance system to identify current poisoning trends, and is a powerful research tool in medical toxicology. All cases evaluated by medical toxicologists at participating institutions in the US are entered into the database. Wiegand and colleagues analyzed the 2011 data from 28 participating centers.

They found that of the 10,392 cases entered into the registry, 53 percent involved patients in emergency departments. The most common reason for consultation with a toxicologist was for pharmaceutical overdoses, which occurred in 48 percent of patients - a combination of intentional overdoses in 37 percent of patients and unintentional in 11 percent of patients. Sleeping pills, muscle relaxants, non-opioid pain relievers (such as acetaminophen and ibuprofen), opioid pain relievers and antidepressants were the most common medications accounting for the consultation.

In addition, there were 35 deaths from medication overdose in 2011, ten of which were attributed to opioids and eight to non-opioid pain relievers. The researchers also observed that cases involving designer drugs, such as psychoactive "bath salts" and synthetic cannabinoids, increased substantially from 2010 to 2011.

Dr. Wiegand concludes: "Much of the current concerns about prescription medication abuse have centered on opioids, and while opioids are certainly of greater concern in regard to morbidity and mortality related to overdose, the data reported here suggest that emphasis should also be placed on sleeping pills. Our data also suggest that while medication abuse is a major problem, restricting our concerns to prescription drug abuse fails to acknowledge the major contribution of nonprescription agents to healthcare resource utilization."