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Early intervention key to reducing youth poisoning deaths

Early intervention key to reducing youth poisoning deaths

Embargoed to 12.01am, Tuesday 27 August 2013

A new report highlights the need to intervene early to prevent unintentional deaths from poisoning in young people.

Between 2002 and 2008 there were 202 poisoning deaths in young New Zealanders aged 15–24. Fifty-five percent were suicides, 35 percent were unintentional, 9 percent were classified as being of undetermined intent, and 1 percent involved assault.

Special Report: Unintentional deaths from poisoning in young people is from the Child and Youth Mortality Review Committee (CYMRC), which operates under the umbrella of the Health Quality & Safety Commission. The CYMRC reviews deaths of children and young people aged 28 days to 24 years and provides advice on how to prevent further deaths.

Poisoning is the second[1] most common cause of unintentional injury death for young people in New Zealand. Volatile substance abuse – also known as sniffing, huffing and bagging – is the cause of most unintentional poisoning deaths, with butane gas often involved.

CYMRC Chair Dr Nick Baker says interventions such as recognising warning signs and improving control of some poisons can save lives.

“For example, it is important to be aware of the risks for young people close to you, give clear support, notice the warning signs of substance use and get help.”

He says while no family is immune to tragic deaths of this type, too often a pattern emerges where problems start very early in life or even before birth, and continue as the child grows, culminating in a life that ends abruptly.

“These underlying problems can include brain damage from alcohol before birth, poor attachment to caregivers, lack of stability while growing up, neglect or abuse.

“Many of the young people who died because of poisoning were not well-connected to support systems, putting them further at risk, with missed opportunities to intervene.”

Dr Baker says it often seems the real risks of substance abuse have not been appreciated by the victims or those around them.

“Substance abuse is often part of a lifestyle that involved risk-taking in a number of settings and death follows a deliberate action without intent to die.

“Lethal agents, such as butane, are too easy to buy and can cause real harm, as can medicines such as opioids – morphine and methadone – when used for purposes they weren’t prescribed for.”

He says it is encouraging that several government initiatives[2] are focusing on the wellbeing of children and young people.

“These offer opportunities to alter outcomes, with early supports for families to improve the environments in which children grow up. Systems are also needed to reduce the attractiveness and availability of the most dangerous substances.

“Greater collaboration and information-sharing between families, communities and with and between service providers is also important.”

Dr Baker says once a volatile substance is inhaled, it quickly crosses from the air in the lungs into the bloodstream, then into the brain and nervous system, interfering with nerve function causing death via unconsciousness or abnormal heart function.

“An alarming number of deaths occur in first-time users, and deaths also occur in experienced users.”

The CYMRC undertook a detailed analysis of the unintentional poisoning deaths of 90 young people aged 15 to 24 years and identified common themes. As well as the cause of death, information considered included case reviews conducted by local child and youth mortality review groups.

The report also calls for safer prescribing, dispensing and disposal of medicines, and law changes to tighten access to harmful substances. Retailers can also do simple things to reduce access, such as removing volatile substances from in-store displays.

To read more about CYMRC’s work, visit http://www.hqsc.govt.nz/our-programmes/mrc/cymrc/

ENDS

Community messages that may save a young person’s life

1. For products that alter alertness, there is a very fine line between drowsiness and death.

a. Every time you engage in huffing or sniffing of solvents, they may kill you.

2. Be aware of the risks for young people close to you, give clear support, notice the warning signs of substance use and get help.[3] Know and use the local pathways that can provide specific help for recreational substance use among children and youth.

3. Learn how to recognise people who are at risk of not breathing and know what to do.

a. If someone does not respond, they may be at risk of death. Get help early. Do not just assume they will ‘sleep it off’ – if in doubt, call an ambulance.

4. Do not pick up prescriptions if you are not going to use them and do not keep medicine ‘just in case’. Safely dispose of all medicine that is not in use.

a. Just because a medicine came from a doctor or pharmacist, do not automatically assume it is ‘safe’. Medicines must be treated like any other poison – safely get rid of medicine as soon as you no longer need it.

b. Return unused prescribed medicines, or medicines past their expiry date, to your pharmacist for safe disposal.[4]

5. Substances prepared by yourself, or those bought on the street, have no safeguards about strength or quality; they can poison and kill unexpectedly.

6. Risks are always greater if you take more than one substance.

7. Volatile solvents are so dangerous that no level of use is safe. Families and others around young people need to know where and how to seek help for any user.

8. If you discover dangerous information about substance use on the internet, report it to NetSafe and the website owner.[5]

9. The dose of methadone or other opioids that is acceptable for one person can easily kill another person.

a. There can be a very fine line between sleep and death.

10. Maintain vigilance for poisoning in young children:

a. Remember ‘out of sight and locked up tight’.6

b. Request child-resistant closures.

c. Be especially alert when away from usual places as there might be hidden risks; this includes visiting others and going on holiday. Breaks from the usual routine may be times when caregivers are distracted and accidents happen.

d. Every child needs a sober caregiver.


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1. Transport-related deaths are the most common injury in young people and drowning is the third most common.

2. The Children’s Action Plan aims to identify, support and protect vulnerable children and has great potential to improve the conditions for healthy child and adolescent development, with early identification of need followed by support and interventions. The Drivers of Crime initiative aims to address the underlying causes of criminal offending and victims’ experiences. Many of the Drivers of Crime initiatives are covered in the Government’s Better Public Service targets, 10 challenging results established in 2012 for the public sector to achieve over the following five years. Improving Youth Mental Health in New Zealand – the Prime Minister’s project for improved mental health and wellbeing for young people. See http://www.ssc.govt.nz/bps-results-for-nzers.

3. For more information on warning signs of substance use and volatile substance abuse (VSA), see: http://www.welltrust.co.nz/The_Early_Warning_Signs and http://volatilesubstances.org.nz/.

4. Information for consumers on the safe use and disposal of medicines can be found on the Medsafe website: http://www.medsafe.govt.nz/consumers/safe.asp.

5. More information on NetSafe can be found at: http://www.netsafe.org.nz/.

6. Safekids New Zealand has a collection of resources to help prevent poisoning in young children – see http://www.safekids.org.nz/index.php/page/45.

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