St. Louis Children’s Hospital and the St. Louis Health Department are working together to minimize the risks of poisoning deaths in the St. Louis area.
Launched in September as part of a one-year pilot program, 1,000 lockboxes are available free of charge through a Health Department grant to families who arrive at the emergency department with a child who has accidentally, or intentionally, ingested medications not meant for them.
These boxes are also provided to families experiencing behavioral health crisis – like suicidal ideation – to prevent self-harm by accessing medications.
“A study from the American Academy of Pediatrics just last year found that child deaths from ingesting prescription medication have risen more than 130% in a decade. Quite frankly, that is unacceptable,” said Dr. Mati Hlatshwayo Davis, St. Louis director of health.
“We are pleased to work with St. Louis Children’s Hospital to provide another way for parents to keep their children safe while preventing unnecessary injuries and deaths.”
The lockboxes are 9.5 inches deep x 6 inches high x 5 inches wide and can hold several containers of medication. The lockbox is locked with a key and padlock – limiting access to only those with the key.
Importantly, the lockboxes are also large enough to hold a small handgun.
In 2020, the St. Louis Children’s Hospital Emergency Department began offering free gun locks to families – with no questions asked. The program now includes over 20 locations across the BJC system.
The city and Children’s Hospital hope to duplicate the success with the lockbox program and curb child overdoses.
According to data from the Missouri Child Fatality Review Program, poisoning deaths in children have increased over the past three years, from an average of 11 poisoning deaths per year to 62 deaths in 2022.
Although car accidents and gun-related injuries still kill more children each year, drug overdoses and poisonings increased by more than 500 percent in 2022.
“A locked box can be crucial to protecting older children, who may impulsively take medications as a form of self-harm or by accident,” said Dr. Lindsay Clukies, a Washington University emergency medicine physician at St. Louis Children’s Hospital.
“It is also important to educate children, teens, and adults on how to prevent accidental exposure, signs of overdose, and what to do in case of an emergency should someone come into contact with misused drugs outside your house.”
In addition to calling 911 in an accidental or intentional ingestion situation, another proactive safety measure is to keep NARCAN, a medication that works quickly to reverse opioid overdose, at home. This can be used for children and adults and is in the form of a nasal spray.
Cluckies recommends that any medications kept in a home are locked away.
A locked box, as opposed to simply storing medications out of reach, is crucial to protecting older children, who may impulsively take medications as a form of self-harm, cases of which Clukies sees in the emergency department.
If you keep fentanyl in your home, consider also keeping NARCAN on hand.
NARCAN® is a brand of naloxone, a medication that works quickly to reverse opioid overdose, including in children, in the form of a nasal spray. NoMoDeaths is a resource that can help you find or order NARCAN® for free in Missouri. For a map of naloxone distribution locations in Illinois, visit the state department of health’s website at https://www.nomodeaths.com/.
If your child is accidentally exposed to fentanyl, NARCAN should immediately be administered and 911 should be called. Naloxone does not cause significant adverse effects in children who have not ingested opioids.
Additionally, if a child is going to a family member or friend’s house for a playdate, parents or guardians need to be aware of what medications and supplements are in the home and how they’re stored.
“Medications need to be added to your playdate safety checklist. This includes marijuana edibles and gummies because consuming products with THC can also harm children, and the products could be laced with fentanyl,” according to Clukies.
“These can be uncomfortable conversations to have, but a neutral and nonjudgmental tone can go a long way in preventing unintentional exposures, and it will give you peace of mind.”