Reports of intentional substance exposures at school nearly quadrupled among elementary-age children

In poison-center coding, "intentional" covers more than drug use. Improper use of a product for any reason other than seeking a high is logged as "intentional misuse". Recreational use to get high is logged separately as "abuse" ^[14]. For children aged 6 to 10, the leading categories were cosmetics and personal care products, arts, crafts and office supplies, and plants at 15% each, plus foreign bodies and toys at 14% ^[11]. Those four add up to 59% of the elementary total ^[4]. Middle schoolers show a similar list, with analgesics entering at 8% ^[17].

The 287% figure starts from a small base. The elementary rate went from 3.1 to 11.9 reports per 100,000 children ^[3], a rise of 8.8, or a factor of about 3.8 ^{[1] [7]}. Middle school added 11.3 per 100,000 ^[2]. In 2024 the elementary rate was still only about 56% of the middle-school rate ^[3]. With the high-school rate falling, all of the overall growth came from the two younger groups ^[6]. "By about 2015, the reported exposure rate among middle-school-aged children had surpassed that among high-school-aged youth," said Hannah Hays, a co-author and medical director of the Central Ohio Poison Center ^[7].

Severity runs the other way. High-school-aged teenagers had the highest rates of serious medical outcomes and hospital admissions, partly because they had higher rates of abuse and suspected self-harm ^[10]. Their leading categories were analgesics (15%), stimulants and street drugs (12%), sedative, hypnotic and antipsychotic medicines (10%), and cough and cold preparations (9%) ^[12]. The three medicine classes alone make up 34% ^[5]. Across all ages, pharmaceutical exposures were about 10 times as likely as nonpharmaceutical ones to produce a serious outcome, and 14 times as likely to end in admission to a noncritical or critical care unit ^[16]. Abuse was more than 4.5 times as likely as other intentional exposures to bring a serious outcome, and suspected self-harm more than twice as likely ^[15].

These ratios come from surveillance data, with no control group. The medicine cases and the craft-supply cases differ in age, motive and substance all at once, so the ratios cannot pin the gap on any one of those.

I think the figures call for two programs aimed at different problems. For young children the products are ordinary school and household items, and the study calls for safe storage at school as well as at home ^[19]. For older students the gap is clinical. "These findings tell us that prevention needs to begin earlier, while older adolescents also need ready access to clinical and mental health support," Hays said ^[8]. Gary Smith, MD, said the rise among younger children, combined with greater severity among high schoolers, "underscores the need for targeted and coordinated prevention and early identification strategies" ^[18].

The counts are calls to U.S. poison centers ^[1]. A reported rate climbs when more exposures happen. It also climbs when more of them get phoned in. The phys.org summary does not include the high-school rate itself or any adjustment for changes in reporting over the 25 years. The study appears in the American Journal of Emergency Medicine ^[6].