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AAPCC Celebrates National Public Health Week

April 6-12 is National Public Health Week, and poisoning remains a critical public health concern for our nation.  As a matter of fact, poisoning is the #1 cause of injury-related death in the United States. It’s true- more people die of poisoning every year than either gun or car-related injuries.  The vast majority of these poisoning deaths are caused by drugs, a category which includes both over-the-counter and prescription medications, plus illicit or “street” drugs.

The U.S. government recognizes poison prevention as an effort critical to the nation’s health, designating the third week of March each year as National Poison Prevention Week, and including poison prevention as an explicit Healthy People objective.

The most important tool we have to help combat poisoning in this country is the national Poison Help phone number, 1 (800) 222-1222.  Clinical experts like nurses, pharmacists, and physicians who are specially trained and certified in toxicology answer the phone from the nation’s 55 poison centers to help people who have poison-related questions, concerns, or emergencies. Best of all, both members of the public and health care practitioners alike can use this invaluable resource any time around the clock, every day of the year, at zero cost to the caller or the patient.  Not only do poison centers provide life-saving treatment advice, they provide poison prevention education as well.  Finally, the American Association of Poison Control Centers manages the National Poison Data System, the only near real-time poison surveillance database available in the U.S.

If you only do one thing in observance of National Public Health Week, save Poison Help as a contact in your phone.  You never know when you might need this critical public health resource.2013 KO and NPPW posters

Krista Osterthaler, MPH

National Public Awareness and Outreach Manager

American Association of Poison Control Centers

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The “Who, What, When, Where, and How” of Poison Centers

The 2013 National Poison Data System (NPDS) Annual Report is now available.  It’s a comprehensive look at the cases managed by the nation’s poison centers over the course of a year.  The staff at the AAPCC central office put together a shorter, more user-friendly summary with graphics for the public and poison prevention educators.  We call it the “Poison Center Data Snapshot” and it’s available here.  It answers the following questions:

  • Who calls the poison center?
  • When someone calls the poison center, who answers the phone?
  • About what kinds of things do people call the poison center?
  • When do people call the poison center?
  • Where do the most poison exposures occur?
  • Why do people call the poison center?

Interested in more detailed poison center data?  Visit http://www.aapcc.org/data-system/.


Krista Osterthaler, MPH
National Public Awareness and Outreach Manager
American Association of Poison Control Centers
Visit www.aapcc.org
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GUEST BLOG: What Happens to Leftover Medicine?

ImageWritten by:

Jeanie Jaramillo

Managing Director, Texas Panhandle Poison Center

Director, Medication Cleanout

Assistant Professor, Texas Tech University Health Sciences Center School of Pharmacy

What Happens to Leftover Medicine?

Most any of us could walk through our homes and find unused, leftover medicines somewhere – the bathroom medicine cabinet, a kitchen cupboard or drawer, perhaps a bedside table.  So, what happens to these medicines?  There was a time when we wouldn’t think much about disposing of leftover medicines by either flushing them or placing them in the trash.  However, as the message about environmental contamination with these agents has reached each of us through the media, we’ve become a society that no longer throws.  What do we do with them?  Unfortunately, we’re not provided with an easy answer and, as a result, many of us simply hold on these medications; storing them indefinitely in our homes.  In fact, in a survey conducted by our poison center through our medication take back program, we have found that ~75% of participants state they would simply keep old medications if they could not have brought them to us for disposal.

Is Leftover Medicine Really a Problem?

Leftover medicine is a big problem that is only getting bigger.  Many poisonings that occur in children are the result of children accessing the medicines on their own.  This occurs when we leave medicines in unsecure places, or when we have them out for our use and fail to return them to a secure location.  Small children like to explore, and they also mimic adults; so, if they see mom or dad taking medicine – they want to do the same.  Most childhood poisonings that require emergency room visits are due to medicines rather than other products around the home.

An even bigger problem occurs when teens decide to experiment with medicines in an attempt to get “high”.  They’ve learned enough to understand that illegal drugs like cocaine and heroin are dangerous.  But they feel that prescription medicines are safe.  If mom and dad keep these agents in the home, they must be safe, right?  And, they were prescribed by a physician.  Teens do not understand the danger of harm and even death that can occur from the inappropriate use of medicines.  Although prescription medicines present a greater risk of harm, even over the counter medications can be harmful when used inappropriately.

And, according to the Centers for Disease Control and Prevention, the abuse of prescription medications is the fastest growing drug problem in the U.S.  Additionally, every 14 minutes, someone loses their life as the result of an unintentional drug overdose.  We, as a society, cannot continue to leave medicines around our homes to serve as a potential source for poisonings and abuse.

What Can I do About it?

As someone who has worked in poison control for many years, the number one recommendation that I give is to get any medicines that are no longer needed out of the house.  I feel that the best method for med disposal at this time is to take any unused medicines to a community medicine take back program.  If a program is not available, another option is mail-back.  Many pharmacies sell envelopes in which medicines can be placed and then mailed for disposal. There are some medicines that should not be mailed, so instructions in the envelopes should be reviewed carefully.  If neither of those are an option, my next best recommendation is to use the kitty litter/coffee grounds method.  Pour the meds into a sealable zipper bag, add kitty litter or coffee grounds and a some water, seal the bag, place it in a disposable container (like a butter tub), and then place it in the trash (preferably directly into an alley or curbside disposal bin).  Although this method still may result in environmental impact, it is preferable over the harm that could occur to family members, friends, acquaintances, or even pets.

Our poison center started a medicine disposal program in 2009 and has conducted 29 events to date.  As a result, we have collected over 15,000 pounds of unused medicines for proper disposal.  These are meds that are no longer available to serve as a source for poisoning or abuse.

What Do Take-Back Programs Do With the Medicine?

Medication take back programs are likely to vary across the U.S. as each state has different environmental and pharmaceutical regulations.  With our program, medicines that are classified as “controlled”, like many pain medicines, are turned over to law enforcement as required by law.  This amounts to about 10% of our collected meds.  All other medicines are sent for incineration at a pharmaceutical-approved facility by a waste management company.  These facilities must meet strict environmental requirements that minimize environmental impact.

How Can People Find Take Back Programs in Their Area?

The U.S. Drug Enforcement Administration (DEA), in coordination with local law enforcement agencies, has been holding National Medicine Take Back days twice a year.  While it is unclear at this time how long the DEA will continue these, they do have a date set for this spring (April 26, 2014.)  Individuals can visit the DEA website at: http://www.deadiversion.usdoj.gov/drug_disposal/takeback/ to determine if an event will be held in their communities.

Many take back programs exist across the country and are supported by various organizations.  In fact, there are too many to list here and I am unaware of a single site for referencing all of these.  I would recommend a general internet search for “medication take back program” as a good starting point.  Also, many local police and/or sheriffs’ departments now have drop boxes available, so a call to an individual’s local police or sheriff department is an option.

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Meet Warren Patitz – Poison Expert at the Indiana Poison Center

When you call the Poison Help line, a poison expert is on the other end of line to help you. While many of these experts are physicians, nurses and pharmacists, they’re also parents, grandparents, sisters, brothers and friends just like you.

The AAPCC is proud to showcase the dedicated professionals at America’s poison centers. Meet this week’s Poison Center Spotlight, Warren Patitz , poison expert at the Indiana Poison Center.

Warren Patitz Spotlight(1)

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MEET JOANN CHAMBERS-EMERSON, POISON EXPERT AT THE FLORIDA POISON INFORMATION CENTER – TAMPA!

When you call the Poison Help line, a poison expert is on the other end of line to help you. While many of these experts are physicians, nurses and pharmacists, they’re also parents, grandparents, sisters, brothers and friends just like you.

The AAPCC is proud to showcase the dedicated professionals at America’s poison centers. Meet this week’s Poison Center Spotlight, JOANN CHAMBERS-EMERSON, poison expert at the FLORIDA POISON INFORMATION CENTER – TAMPA.

JoAnn Chambers-Emerson Spotlight Copy(1)

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Guest Blog: Deborah Blum, Pulitzer Prize Winning Science Journalist, Author of NYT Best Seller

We had the wonderful opportunity to ask Deborah Blum, a New York Times Bestselling author, Pulitzer Prize winning journalist and expert on poison subjects, a few questions. Blum is a self-proclaimed fan of the poison center system and shared her views on everything from science education to poison history.

1. There are so blummany things you could write about. Why poison?

I know – I worry sometimes that it makes me sound a little twisted. It really started because I had been thinking about a kind of subversive way to write about chemistry. I really find chemistry fascinating – the kind of intricate puzzle of it that builds like on Earth. But I also know that many people learned in high school to find it off putting. So essentially I was thinking about a story that was so compelling – like a murder story – that I could weave the chemistry seamlessly into it. That’s part of it.

The other part, I suppose, is that I grew up reading Agatha Christie. So I was intrigued by the idea of telling the book – this would be The Poisoner’s Handbook – with the pacing of an early 20th century murder mystery. I wanted to take readers on a detective journey, like the scientists of my story they would be  trying to figure out how poisons work. But I give them the clues. So this is both the story of two scientists trying to build a science of forensic toxicology but it is a handbook of a poisons, every chapter is focused on one toxic substance and tells its story.

2. Many writers choose topics they feel empower their readers by giving them an appreciation for something they might not otherwise understand.  What do you hope your readers take away from your writings, particularly your book “The Poisoner’s Handbook?”

Well, as I just emphasized Poisoner’s Handbook is a historical look at forensic toxicology. And I think that’s important. We can’t understand where we are unless we know how we got here. And this story tells us how new our “CSI era” is, how recent forensic science is, and helps us understand that we’re still figuring out how to navigate our chemical world. But, I hope, it also provides a very common sense perspective on poisonous substances. For instance, there are two chapters focused on carbon monoxide – which remains a public health problem even today. So I hope it also offers a common sense, take care of yourself kind of perspective on dangerous chemistry.

3. The accurate portrayal of science in the media is a growing concern. Are you concerned about toxicology is portrayed by the media?  When it comes to poison information, what do you believe is the most important concern regarding accuracy and what steps do you recommend to ensure that your work addresses this concern?

I think we members of the media tend to spend too much time focusing on what I think of as “poster child”  compounds – such as BPA – which raises some interesting questions about endocrine effects but is not what I think of as a class A danger.  It’s kind of a pack journalism effect. Those compounds get lots of attention and lots of coverage. Meanwhile, there are less trendy but more dangerous substances – carbon monoxide, for instance, (which I make a point of writing about every year), or lead and other metallic elements, over the counter , which more directly harm people and it’s frustrating to me that they often get lost in the media noise.

And regarding accuracy? Lots of homework, interviews and like most dedicated beat reporters, I think, I develop a group of scientists who become an informal peer review system so that I can check or even double check ideas and information.

4. With your comprehensive knowledge of poisons and poison history, how would you characterize the evolving role of poison centers in America’s public health system?

I’ve downloaded and studied the annual reviews by poison control centers and I’m always struck by much I learn from them. Some of my own sense of what matters and what’s dangerous have come from reading those reports. I think poison control centers have ground into one of our most important public health resources. They identify patterns as risks emerge and change, they offer information on the science, and on an emergency basis they help frightened families get through critical events. I wish, actually, that we put even more resources into them than we do now.

5. As an experienced science educator, what trends in access to basic science education have you noticed and how do you think those trends will impact
 the upcoming generation of scientists?

I’m a big believer in science literacy so I’m hoping that we’re learning to do a better job of educating the non-scientists as well as the scientists. I always think we could do a better job of training future generations of researchers – and also in investing in research so we can take advantage of that potential. But I also believe that we need to focus on those who don’t want to be scientists but DO needs to have a common sense understanding of what it is and how it’s helpful in their lives. My younger son took a class in forensic science when he was a senior in high school and they turned one room of the school into a “crime scene.” They had to solve crimes using everything from urinalysis to fingerprinting to DNA analysis. And with every unit, they learned something about science and how it works and why it matters in their lives. I actually think that as a country we’d be investing more in science now if we’d done a better job of engaging everyone in the story. So I hope this is an actual trend in the right direction.



6. What is your favorite piece that you’ve ever written?

Oh, there are so many! My favorites are ones in which there’s a story behind the story. For instance, I wrote an e-single for The Atavist called “Angel Killer” about a really crazy (and terrible) 1930s serial killer. It’s his story but it’s also the story of the ethical dilemma we face in dealing with really crazy people. I love that kind of deeper backstory to a piece. And there’s a piece I wrote about carbon monoxide poisoning called “Poison in the Night” which I love for that reason (it’s really a PSA) but because I told it in such a literary way – I think – that it’s one of the most subtle PSAs ever to say “GET A CARBON MONOXIDE DETECTOR”. So I guess I’m telling you there’s not just one.



7. Poison is an intriguing topic. While shows such as CSI that feature forensic toxicology enjoy a growing audience, poison center educators sometimes find that it’s difficult to get the public’s attention when it comes to following home-based poison prevention safety measures.  What is the key to making people appreciate the dangers of common, everyday poisons when they aren’t wrapped up in intrigue?

That’s a really good question. And a frustrating issue. I’m a big believer actually in just repeating myself – GET A CARBON MONOXIDE DETECTOR – in many different ways. Just wrote a piece about carbon monoxide deaths in hotels which pretty much says the same thing again. I wish there was a magic answer here. But I don’t think there is one because for reasons I don’t understand we’re so slow in learning how to take care of ourselves. So I don’t know what to do except to keep telling the story in different ways, keep hitting people over the head with it until some of them get it at least.

Of course, you can always get smart writers like me to do some of that work!

Deborah Blum is a Pulitzer-Prize winning science writer and the author of five books, most recently the best-seller, The Poisoner’s Handbook: Murder and the Birth of Forensic Medicine in Jazz Age New York. She writes for a range of publications including Time, Scientific American, Slate, The Wall Street Journal, The Los Angeles Times (and even the literary journal, Tin House). She is currently working on a sixth book about poisonous food. (Biography courtesy of Wired.com)