Why Parents Should Routinely Check Their Medicine Cabinet: A Doctor’s Guide to Potential Poisons at Home

When most parents think about drugs, they tend to picture teenagers being pressured by peers or dealers hawking illegal substances. While it’s smart to talk to teens about the dangers of experimenting with illicit drugs, that isn’t the only “drug problem” that should be on your radar: You probably have a number of perfectly legal drugs in your medicine cabinet right now that can harm or even be fatal for someone in your family—and babies and toddlers are especially vulnerable.

Nearly half of all poison exposures occur in children under age 6

Nearly half of all poison exposures occur in children under age 6, according to the National Capital Poison Center. While these incidents include things like ingesting cosmetics, personal care products, and household cleaners, little ones getting into over-the-counter and prescription medication is a more serious concern.

During my time working in a pediatric emergency room, I treated dozens of children who were the victims of accidental drug overdoses. In some instances, parents would rush in with a child after finding them near a bottle of spilled pills on the floor. In other cases, parents would bring in a child who was acting strangely but they weren’t sure why; later it would be discovered that the child had ingested medication in the home and the effects were finally kicking in.

Although health care providers will take quick action to treat children who they know have been poisoned by medication, it often is extremely difficult to determine whether a poisoning has even taken place. Some of the common early symptoms of poisoning, such as vomiting or sleepiness, may also be the result of trauma or other medical conditions. Even when a poisoning has been discovered and treated, doctors’ efforts are sadly not always successful: According to the Centers for Disease Control and Prevention (CDC), two children die every day as a result of being poisoned by a medication or household substance.

Which drugs should you be most concerned about?

Over-the-counter pain relievers, such as acetaminophen (Tylenol) and ibuprofen (Advil and Motrin), are ingested accidentally quite often, simply because they’re found in nearly every home. Luckily most toddlers won’t take enough to cause harm, but either of these drugs in sufficient quantity can be deadly to a small child. Acetaminophen overdose is particularly dangerous because symptoms like nausea, vomiting and abdominal pain, can resolve within a day or so and only return when the child’s liver is failing.

Keep in mind that some drugs, like liquid cold medicine, may be more enticing because they taste sweet. If a child takes a large enough quantity of a formula that contains an antihistamine or cough suppressant, they may experience unusual sleepiness, shallow breathing, and hallucinations. Same goes for chewable aspirin: The sweet taste and easy-to-chew tablets that a grownup might have on hand to protect their heart can be poisonous to small kids. Aspirin overdose may be recognized early by abnormal, rapid breathing and requires immediate medical attention.

In addition to aspirin, other cardiac medications, including blood pressure medication, are very common in American households. Medication that’s designed to lower high blood pressure can be very dangerous for small children, and since many formulas are delayed- or sustained-release, the symptoms might not become apparent for hours.

The drugs that most commonly cause serious or deadly effects in American households, however, are now prescription painkillers. In the past, sleeping pills like zolpidem (Ambien), and anti-anxiety drugs like alprazolam (Xanax) and diazepam (Valium) were more common, and they’re certainly still very dangerous for smaller children as even one or two pills can alter consciousness. However, beginning in 1991, prescription opioids became increasingly prescribed in the U.S., and by 2008 poisoning fatalities exceeded motor vehicle traffic fatalities.

Anytime you suspect that a child has gotten into medication, call the National Poison Control Hotline (800-222-1222) immediately and you will be automatically connected with your local poison control center. Expect to answer a number of questions about your child’s condition and the drug that was ingested. If you don’t recognize the pills, the RxSaver Pill Identifier can help you search quickly by imprint, shape, or color.

Depending on what has been ingested and the symptoms your child is experiencing, the specialist may simply advise you to monitor your child—or you may be directed to head to the hospital. Call 911 immediately if a child is unconscious or has altered behavior, won’t wake up, has seizure-like movements, or is having difficulty breathing.

Of course, the best remedy is to prevent accident drug overdoses from happening in the first place. Here are some tips to help keep your youngsters safe.

If you have a crawler…

Babies who are mobile are tactile adventure-seekers. They have no qualms about putting anything and everything in their mouths, even if it’s lurking under the couch or next to the dog’s bowl. If you drop a loose pill, you can bet that they’re going to find it and eat it. While you’re probably not intentionally throwing pills on the floor, be extra cautious. If you do lose your grip on a pill, plan to spend some time searching for it (or thoroughly vacuuming).

If you have a toddler…

Toddlers are the ones at greatest risk for accidental drug overdoses. Not only do they move around, but they also climb. They’re extremely curious, yet they don’t have much common sense (or sense of fear) to help keep them safe.

Most parents know not to keep pills and other dangerous substances in low cabinets, like under the sink. But once a toddler starts climbing, watch out: A cabinet that’s over the sink might suddenly become just as accessible. Don’t assume that childproof caps on medication will deter a child, either. Some kids manage to get these caps off, especially if an adult fails to adequately secure them after taking a pill.

The best place for medications is somewhere that’s as inaccessible as possible—think an upper shelf inside your clothing closet or the highest shelf in your kitchen. (Your bathroom medicine cabinet isn’t ideal, because kids can climb onto the counter to reach it, plus moisture can degrade medication.)

Be extra cautious about plastic pill sorters; in addition to being easy to open, they tend to come in bright colors that make medicine look even more enticing to children. If you must use one of these to keep track of a complicated drug regimen, make sure it’s out of sight—and far out of reach. Since children are natural mimics, I tell parents not to take their daily medication in front of their children so kids won’t try to imitate the action.

Meanwhile, parents and caregivers must be on high alert when they’re at someone else’s place. Your medications might be properly secured at your home, but what happens at Grandma’s house or when you’re visiting a friend? Be sure to scope out the area so you can move drugs out of reach and be diligent about supervising your child at all times in new surroundings.

You should also take some time to consider how you store meds when you’re on-the-go. Many people carry pills in small pouches or pill boxes; that may be unavoidable, but try to make it as difficult as possible for a toddler rummaging through your purse to get to it. Think lots of layers—maybe put a pill box inside a zippered pouch and put the whole thing inside a zippered compartment of your purse. The more barriers, the better.

If you have an older child/teenager…

As kids get older, accidental drug poisoning becomes less of a concern. Unfortunately, a new problem—deliberate experimentation or intentional overdose—may take its place.

Tweens and teens tend to be left home alone more often, and some exploration is a normal part of adolescence. The best thing you can do is to try to educate your kids about the dangers of using medication improperly and dispel common myths. You should also emphasize that it can be very dangerous to take medication that’s been prescribed for somebody else. Start as early as possible, ideally between ages 8-10, so that they hear good info from you before they get “educated” by their peers.

While some kids may experiment with taking high doses of over-the-counter pain relievers or sleeping pills (suicide attempts involving self-poisonings doubled among teens younger than 19 between the year 2000 and 2018), the legal drugs most apt to be abused for recreational purposes are opioids like oxycodone (OxyContin), hydrocodone (Vicodin), codeine, and morphine.

Opioids have the potential to be highly addictive. If you must have opioids in the house— perhaps you have a chronic pain condition or recently had surgery — consider locking it up or counting pills so that you’d know right away if any were missing.

No matter how old your kids are, it’s wise to give your medicine stash a monthly checkup. If there’s anything on hand that’s no longer needed, get rid of it. That includes anything that’s expired as well as prescription drugs that you no longer need to take. Do not save medication—especially opioid pain medication—”just in case.” It’s far safer to get it out of your home so it cannot be used improperly.

The best way to get rid of unneeded medication, according to the FDA, is to find a take-back program. You can find a safe disposal site by clicking here.

If those options don’t exist in your area, opioids are among the few drugs that should be flushed down the toilet to prevent a child, pet, or another person from the dangerous effects. Most other medications can be mixed with dirt, kitty litter, or coffee grounds, then put into a sealed plastic bag and thrown away with your household trash.