The U.S. DEA is working with local police agencies to hold a medication take-back this Saturday, October 26, from 10 a.m. to 2 p.m. This is a great chance for you to get rid of old medications that are either expired or that you no longer need.
Visit the DEA’s take-back page to find a disposal location near you.
Getting rid of medications in a safe way helps keep them from:
There have been numerous news reports recently about a party drug called “Molly” that has been making the rounds, especially at concerts. Close to home, the drug has been potentially linked to three overdoses at the House of Blues in Boston, which led to the death of a UNH student.
Dr. Karen Simone
We talked to our director, Dr. Karen Simone, to help clarify what we know and what we don’t about Molly.
What is Molly? Is it similar to other drugs?
Dr. Karen Simone: We are not always sure. “Molly” is currently being used to refer a very pure form of ecstasy or a similar drug (TFMPP). However, there is no “street FDA,” and we suspect that Molly may contain other stimulants.
The bottom line is that we know what Molly might be, but are never really sure. Usually it is some sort of amphetamine-like drug with hallucinogenic or mind-altering effects.
What are the health risks of using Molly?
KS: Molly has serious risks. There are recent reports of deaths and near-deaths. It can lead to agitation, high body temperature, seizures, muscle breakdown, kidney damage and sometimes liver damage.
Are there situations where it’s more dangerous to use Molly?
KS: If it is especially hot outside, it may be more likely that increased body temperature will be a problem. If you take medications, especially for depression or other mental disorders, they may increase the chances of a harmful reaction to Molly. Using other street drugs may also increase the risk.
It appears that some batches of Molly are different from or stronger than others. These may be more likely to cause a problem.
There have been some deaths from using Molly. What are the signs a person needs medical help? Who should they call?
KS: It is not safe to wait if someone is having a harmful reaction. The person could die or have permanent brain damage.
Call 911 right away if the person:
If you are unsure how serious the problem is or if you cannot tell if there is a problem, call the poison center at 1-800-222-1222 for advice. You do not have to identify yourself or the person in trouble.
It is not safe to wait if you know there is a problem. The person could die or have permanent brain damage.
Call the poison center at 1-800-222-1222 or chat online if you have other questions about Molly.
The Northern New England Poison Center is pleased to welcome Dr. Tammi Schaeffer as our new medical director!
Dr. Schaeffer comes to us from the Rocky Mountain Poison and Drug Center in Denver, where she was an attending medical toxicologist, providing clinical care and management of poisoned patients, as well as teaching medical toxicology fellows.
No stranger to New England, Dr. Schaeffer earned her DO from the University of New England College of Osteopathic Medicine in Biddeford, Maine, in 2001. Prior to that she was a paramedic in her home state of New Jersey for nearly 12 years after earning a BA from Rutgers University.
Dr. Schaeffer completed her internship and residency at Morristown Memorial Hospital in New Jersey before joining the Rocky Mountain center in 2004 as a medical toxicology fellow. She joined the staff in 2006.
Dr. Schaeffer has also worked as an emergency medicine doctor at Littleton Adventist Hospital in Colorado, served as an assistant clinical professor for the medical schools at the University of Colorado and Rocky Vista University, and worked in private practice, providing both toxicology and non-clinical consulting services.
We are excited to have Dr. Schaeffer aboard, but also saddened by the departure of Dr. Tamas Peredy, who is joining the Florida Poison Information Center in Tampa as the medical director.
Dr. Peredy has been our medical director since 2006, and an emergency medicine doctor at Maine Medical Center since 2000. We are going to miss him greatly, and we wish him all the best in his new position!
When was the last time you wore personal protective equipment (PPE), such as gloves or safety glasses? Do you have to wear it for work? Or maybe you’d have to go back to high school chemistry class?
But school and work aren’t the only places you need PPE. In fact, if you’re not wearing safety glasses at home, you might be putting your eyes at risk.
Anytime you’re using chemicals like cleaning products, pesticides and car products, there’s a chance you could get some in your eyes. It doesn’t matter if your at home, school or work. In fact, three out of four eye poisonings that are called into the poison center happen at home.
Cleaning products are the most common substances involved in eye injuries managed by the poison center. Check out the video below to see how easily it could happen to you and how you should handle an eye exposure (starts at 5:56).
Remember, always read the label of any product you are using for safety instructions, and wear safety goggles when it is recommended.
If you do get a chemical in your eye, call the poison center right away at 1-800-222-1222. In most cases, we can help you treat the eye exposure right where you are, without having to go to a hospital.
Whether it’s that spider building its web in the corner of your bathroom or a snake in your garden, you may have wondered if that creepy-crawly thing was poisonous.
If you live in Northern New England, the answer is most likely no.
One of the many great things about living in our region is that there are virtually no native animals that can poison humans. And the ones that do live here are very uncommon—you’re not likely to run into one. The NNEPC gets very few calls about poisonous animals each year.
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| A timber rattlesnake in Shenandoah National Park in Virginia |
One poisonous critter we do have in our area is the timber rattlesnake. The bite of this snake can actually be quite dangerous, but they only live in certain wooded areas in Vermont and New Hampshire and are considered endangered. A timber rattler would much rather get away from you than bite you and will usually let you know it’s upset by shaking its rattle.
In theory, we also have the northern black widow spider in our region, but they are so rare that one local spider expert told us that he only ever found one during his his whole career.
Of the few calls we do get at the NNEPC, many are about bites from exotic snakes that people keep as pets—most of these snakes are not poisonous, but some are. As for spiders, the southern black widow, which is the most well-known type of black widow, will occasionally hitch-hike up our way with fruits or vegetables, such as grapes. The brown recluse is a well-known poisonous spider, but they do not live here and are not known for traveling.
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| A Southern black widow that came to northern New England in some produce. Photos courtesy of Jim Prive. |
If you think you have been bitten by a poisonous animal, call the poison center at 1-800-222-1222 or chat online. If you are able to take a picture of the animal, that can help us identify it, but the most important things are to stay safe—don’t get bitten again!—and to keep the bite area stable.
Eric Frohmberg is the manager of the Maine Childhood Lead Poisoning Prevention Program and the chair of the Maine Healthy Homes Advisory Council. We asked him some questions about Healthy Homes. For more information, visit www.maine.gov/healthyhomes.
Can you explain the Healthy Homes concept?
Eric Frohmberg: If you think about how most of your life is spent, like many people, you probably spend about one third at work, school or busy in the community, one third at home and one third asleep, which means that you spend a lot of time in and around your home. As a society we have spent resources on making sure workplaces and schools are safe, but have spent very little on coordinated resources to help people ensure their homes are healthy and safe.
In the past, state and federal agencies have been addressing home health and safety issues as discrete problems. For example, we have programs to help fix lead paint problems which are completely separate from the programs that help with radon mitigation or fire prevention or pest control. The idea behind healthy homes is to coordinate responses and resources to address multiple issues at once.
Can you briefly explain how the Maine Healthy Homes Advisory Council works?
EF: The Maine Healthy Homes Advisory Council works to coordinate state and non-state agencies that provide advice on home-related health and safety issues. At its simplest, that means providing one area for the public and service providers to find information about home-related hazards (maine.gov/healthyhomes), coordinating activities so that limited resources are used effectively, and identifying gaps or needs that are currently not being addressed.
Healthy Homes is a broad concept, what are a few key things everyone should know to keep a home healthy?
EF:
| Have questions about the effects of poisoning from lead, carbon monoxide, radon or pesticides? Call the poison center at 1-800-222-1222 or chat online. |
and live in a pre-1950 home, get a free kit to see if you have dust from lead paint.
What are some ways that Healthy Homes has worked with or made use of the poison center? Do you see other ways that poison centers and Healthy Homes programs can collaborate?
EF: Accidental poisonings are an important Healthy Homes issue. The Northern New England Poison Center is part of the Healthy Homes Advisory Council and provides a unique perspective on their focus area of Healthy Homes. We incorporate their materials and perspectives when we do education and outreach to our target audiences, and they do the same with us. The Northern New England Poison Control Center also acts as our clinical resource for any kind of poisoning issue
What do you hope to see in the next five years to improve home-related health issues in Northern New England and the U.S.? Are there any potential policies or laws that you think would significantly improve the health and safety of Maine residents?
EF: Maine has one of the oldest housing stocks in the country. Many of those homes have not been maintained properly due to lack of funds. So old lead paint is peeling, roofs are leaking and many have damp dirt floors in the basements, which can contribute to mold growth. While there are funds to help address some of these issues the funds are much less than the need. The result is more Maine families needlessly suffering from lead poisoning, asthma and other health conditions. This puts a burden on the medical care system and costs the state much more money than by acting proactively to address these issues before someone gets sick.
Recognizing this imbalance, the Healthy Homes Advisory Council is currently conducting a needs assessment. Through this process we are identifying the existing resources and needs within the state, and identifying gaps in strategies and funding among the various types of home-related health and safety activities. At the completion of the assessment, it is my hope that programs will have the information they need to better coordinate efforts and work together to procure funding to address gaps.
If you’ve ever traveled on a plane with a young child, you may have been tempted to give them a dose of Benadryl (diphenhydramine) to make them sleepy. While you wouldn’t be alone, this is really not a safe way to handle the stress of traveling with kids.
Diphenydramine is found in many allergy, sleeping and night-time cold and pain medications. If you give too much to a child, it can cause a fast heartbeat, trouble breathing, confusion and agitation. That last one might surprise you, but for some kids, diphenydramine may actually make them more fidgety or excitable, rather than making them sleepy. For these reasons, labels on medications that contain diphenhydramine include the warning “Do not use to sedate or make a child sleepy.”
Using a product in a way other than those listed on the label—misuse—is one of the three ways that something that is normally safe can become poisonous. The others are using too much of the product, and mixing it with another product in a way that causes one or both to become dangerous.
If you are flying with a young child, consider bringing books or new toys to keep them distracted. Have something for your child to drink during takeoff and landing to help with the pressure change.
Remember, if you have questions about medications while traveling, you can reach a poison center from anywhere in the U.S. by calling 1-800-222-1222.
Just because you are pregnant doesn’t mean you won’t get ordinary aches and pains, like headaches or a cold. I rarely have pain other than the occasional headache, but when I was pregnant I had a lot of back pain, frequent headaches, a stuffy nose and De Quervain syndrome (also known as mother’s wrist—pain and swelling on the thumb side of the wrist). I knew what I would take if I wasn’t pregnant, but wasn’t sure it would be safe for my baby. So I asked my doctor.
It is important to talk to your doctor or pharmacist before you begin taking any medications, vitamins or herbs. Even “natural” products like herbs, minerals or amino acids are not necessarily safe. Drug companies can’t test medications on pregnant women, so in many cases we don’t have much information on how they can affect a women and her baby.
If you are pregnant and want to take a medication, talk to your doctor. Ask if there are any known safe alternatives. For example, maybe an ice pack would work for pain instead of medication. Ginger root or frequent eating and drinking may relieve nausea.
For some women, ongoing health conditions like high blood pressure and diabetes can actually get worse during pregnancy. There are several pregnancy exposure registries to help you learn which medications for these conditions are safe to take while pregnant. These registries are not run by the U.S. Food and Drug Administration, but the FDA does keep a list of all of them, where you can look for your medication or medical condition.
Just recently the FDA released a warning that pregnant mothers should not take certain migraine medications because they can lower children’s IQ scores. This warning was a result of the findings from the antiepileptic drug pregnancy registry.
If you are pregnant or thinking of becoming pregnant and take medication for an ongoing medical condition, contact a pregnancy exposure registry to learn more about your risks and options.
For North American Occupational Safety and Health Week, we spoke with Dr. Karla Armenti, the principal investigator for the Occupational Health Surveillance Program within the New Hampshire Department of Health and Human Services. She has been analyzing poison center data to look for trends in workplace poisonings.
What are the main occupational safety and health issues for New Hampshire employees today?
Karla Armenti: Actually we are continuing to see a steady number of occupational poisoning exposures as reported to the poison center. The numbers have remained consistent for most substances, however upon analysis, we see an increase in exposures involving cleaning substances used in industrial or janitorial (cleaning industry) environments.
Other issues of concern involve ergonomic-related, or musculoskeletal injuries involving upper extremities and low back.
Our work-related fatality rate has increased, especially in 2012, where we had 14 fatalities. Of these, 4 involved tree-cutting activities.
You recently did a survey of immigrants in New Hampshire to better understand the occupational health of this working population. What was the most important thing you learned in your research?
KA: 62% of those surveyed had never heard of workers’ compensation and did not understand what their rights were when injured at work.
Many of our immigrants (including refugees settled in New Hampshire) were highly educated in their home country, but the only job they could get here was in cleaning or home health care. They reported that they knew when conditions at work were not safe but were fearful of losing their job. They often reported no knowledge of OSHA or workplace safety regulations. There is a critical lack of understanding about their employer’s responsibilities in this country with regard to keeping them safe at work.
The NNEPC manages approximately 150 occupational poisonings a year in New Hampshire. You have been analyzing our data to better understand this issue. What are some interesting findings? How has this data been useful to your work?
KA: Yes, our New Hampshire poison center data are critical to our surveillance efforts. We recently completed a study looking at data from 2009 to 2011 and found that chemicals, household and industrial cleaning substances, fumes/gases/vapors, heavy metals, and hydrocarbons are among the top contributors to occupational exposures in New Hampshire. We also see that among all age groups, the number of cases was greater for males than for females and the most common age group for both genders was the 20s. The highest percent for exposure route was inhalation, with dermal and ocular exposures evenly distributed, while ingestion was the lowest.
Despite existing intervention and education efforts, reported occupational exposure rates have remained relatively steady since 2005. The substances involved in the most exposures are widely used in workplace environments, and should be a focus of public health injury prevention efforts. While safety training, better enforcement of safe practices, and improved preventive maintenance of equipment are important interventions for these risks, ultimately the most effective intervention would be to limit the use of potential poisons in the workplace.
It is noteworthy that a number of the poisonings in our study occurred during a cleaning activity, performed across different types of businesses. While cleaning is often necessary in many industrial sectors, specific cleaning chemicals are not essential per se to the production process or final product. Thus, cleaning could be targeted as a high priority for substituting toxic substances with less hazardous ones to prevent workplace poisonings.
What do you hope to see happen to improve occupational safety and health in Northern New England and the U.S. in the next 5-10 years?
I would like to see an increased focus on primary prevention that includes stronger efforts to eliminate hazards in the workplace through design and chemical substitution.
There is a lot of promise in workplace wellness and health promotion activities; however, there must be a concerted effort to integrate workplace safety and health into these strategies for a more holistic and successful approach. We often spend more than 8 hours a day at work. We need to understand that what we do at work influences our health just as much as anything else we do–and maybe more!
Suicide is a complex issue involving multiple factors. According to the Surgeon General’s 2012 National Strategy for Suicide Prevention, “There is no single path that will lead to suicide. Rather, throughout life, a combination of factors, such as a serious mental illness, alcohol abuse, a painful loss, exposure to violence, or social isolation may increase the risk of suicidal thoughts and behaviors.”
Preventing suicides requires programs that reduce these negative factors and promote resilience and supportive relationships during difficult times. On a personal level, we need to be able to recognize warning signs of suicide and keep the person safe until they get help from a trained professional.
Warning signs of suicide include:
The more warning signs a person has, the greater the risk of suicide. If you think someone is at risk, do not leave them alone. Be sure to remove firearms and poisons (such as medications), call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), and take the person to the emergency department or connect them with a medical or mental health clinic.
If you live with someone who has a history of substance abuse or suicidal behavior, always keep firearms and other lethal items in a locked cabinet, and buy only small quantities of medications you need and store them in a locked box. Dispose of unwanted medications frequently – participate in local medication take back events.
To learn more about suicide prevention programs and recommendations read the 2012 National Strategy for Suicide Prevention: Goals and Objectives for Action.
If you have questions about a possible poisoning, call the poison center at 1-800-222-1222 or chat online.
According to the CDC, suicide was the 10th leading cause of death [PDF] in the U.S. in 2010 with 38,364 suicides, a rate of 12.4 per 100,000. Northern New England states rates were all above the national average [PDF] with Vermont ranked 12th (16.9 per 100,000), New Hampshire 18th (14.9) and Maine 26th (14.0).
Nationally, males account for 79% of all suicides and are more likely to use a firearm. The rates are highest for males among those 75 years and older. Females are more likely to use poisoning and the rate of suicide is highest among those 45-54 years of age.
In 2010, there were an estimated 465,000 people with self-inflicted injuries treated in the emergency department, up from 374,500 in 2009.
According to the American Association of Poison Control Centers, in 2010 nearly 220,000 [PDF] suspected suicide attempt poisoning cases were managed by U.S. poison centers. The Northern New England Poison Center managed nearly 3,300 of these. Patients under 20 were more likely to use readily-available substances such as over-the-counter pain relievers, while patients 20 and older were more likely to use prescription medications, including benzodiazepines and painkillers.
Suicide is preventable. If you feel you are in a crisis or know someone who is, call the National Suicide Prevention Lifeline at 1-800-800-273-TALK (8255).
Do you remember Mr. Yuk?
Mr. Yuk: No longer used
Many poison centers used to give parents Mr. Yuk stickers to put on poisonous things. The idea was that kids would learn to stay away from products that had the Mr. Yuk sticker on them. It was a good concept and very popular tool.
However, studies showed that Mr. Yuk wasn’t effective. Parents couldn’t realistically put stickers on every possible poison, so even if their child was really well trained to stay away from things with the sticker, they might think it was OK to play with products that didn’t have it. Some kids may have been attracted to the sticker, too.
Maybe more importantly, the kids targeted with the campaign—young school-aged kids—are not the real high-risk group. Children ages 13 months to 2 years are the most at risk for poisoning. In fact, they accounted for nearly 25% of all poisoning calls to the NNEPC in 2012.
Given all of this, most poison centers phased out using Mr. Yuk over a decade ago.
The sticker also couldn’t always help for medication. Medication is the most common cause of poisoning among young children, and they frequently get loose pills that have fallen to the floor. A study released this year by Safe Kids Worldwide found that among children treated for medication-related poisonings in an emergency room in 2011, 27% had found the medicine on the ground or misplaced. The next most common places they found medication were in a purse, bag or wallet (20%), on a counter, dresser, table or nightstand (20%), and in a bag of pills or pillbox (15%). The medications most often belonged to a grandparent (38%).
This report is a reminder to keep all medications in child-resistant packaging and out of the reach of children, and to be careful to not leave loose pills lying around. And programming your cell phone with the poison center phone number, 1-800-222-1222, is the best way to be prepared in case a child does get into some medication.
