The population-based rate of reported intentional substance exposures at school among U.S. children increased 77.5% from 2000 to 2024, with the largest jump among elementary-school-aged children, according to a study published in The American Journal of Emergency Medicine.
Researchers at the Center for Injury Research and Policy at Columbus, Ohio-based Nationwide Children’s Hospital and the Central Ohio Poison Center analyzed National Poison Data System data in a retrospective cohort study. Intentional exposures included intentional misuse, abuse and suspected self-harm or suicidal intent.
Here are five things to know:
1. Among elementary-school-aged children, ages 6-10, the rate increased 287%, from 3.1 to 11.9 reports per 100,000 children. Among middle-school-aged children, ages 11-13, it increased 112%, from 10 to 21.3, surpassing the high school rate around 2015. Among high-school-aged children, ages 14-18, it decreased 4%.
2. High-school-aged teenagers accounted for 46% of reported intentional substance exposures at school and continued to experience the highest rates of serious medical outcomes and hospital admissions.
3. Intentional misuse accounted for 62% of intentional substance exposures at school, while abuse accounted for 24% and suspected self-harm or suicidal intent accounted for 14%. Abuse-related exposures were more than 4.5 times more likely to result in a serious medical outcome than non-abuse intentional exposures. Exposures involving suspected self-harm or suicidal intent were more than two times more likely to result in a serious medical outcome than exposures not related to suspected self-harm or suicidal intent.
4. The leading substance categories varied by age. Among children ages 6-10, cosmetics/personal care products, arts/crafts/office supplies and plants each accounted for 15% of exposures, while foreign bodies/toys/miscellaneous accounted for 14%. Among children ages 11-13, cosmetics/personal care products accounted for 13%, arts/crafts/office supplies for 11%, foreign bodies/toys/miscellaneous for 8% and analgesics for 8%. Among those ages 14-18, analgesics accounted for 15%, stimulants and street drugs for 12%, sedative/hypnotic/antipsychotic medications for 10% and cough and cold preparations for 9%.
5. Overall, pharmaceutical exposures were associated with greater medical severity. Their likelihood of a serious medical outcome was about 10 times that of non-pharmaceutical substance exposures, while their likelihood of admission to a non-critical or critical care unit was 14 times as high.
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