A recent study revealed a notable rise in intentional substance exposures among elementary and middle school children reported to U.S. poison centers between 2000 and 2024. Research conducted by the Center for Injury Research and Policy at the Abigail Wexner Research Institute at Nationwide Children’s Hospital in conjunction with the Central Ohio Poison Center found that the overall rate of such exposures in schools surged by 77.5% during this period.
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Specifically, the rate of reported intentional substance exposures increased by 287% among elementary school-aged children (from 3.1 to 11.9 cases per 100,000 children) and by 112% among middle school-aged children (from 10 to 21.3 per 100,000 children). In contrast, the rate for high school-aged students fell by 4%.
Hannah Hays, MD, co-author and medical director at the Central Ohio Poison Center, highlighted a significant shift in age patterns over time. By 2015, middle school-aged children had higher reported exposure rates than high school students, despite the latter group experiencing the most severe medical outcomes. Hays emphasized the need for early prevention efforts while ensuring access to clinical and mental health support for older adolescents.
High school students represented nearly half (46%) of all intentional exposures at school, with a significant portion of their serious medical cases attributed to substance abuse and suspected self-harm.
Different categories of substances led to varying rates of exposure among age groups. For elementary school children (ages 6–10), common exposures included cosmetics/personal care products (15%), arts/crafts/office supplies (15%), and plants (15%). Among middle school children (ages 11–13), the leading substances were similar, with 13% related to cosmetics and 11% to arts/crafts/office supplies. High school students (ages 14–18) most frequently reported exposure to analgesics (15%) and stimulants/street drugs (12%).
Overall, 62% of intentional exposures at schools were attributed to misuse, while 24% were due to abuse, and 14% were related to suspected self-harm. The study also revealed that abuse was more than four times as likely to result in severe medical outcomes compared to non-abuse-related exposures.
The findings underscore the necessity for tailored prevention strategies and clinical responses in both home and school environments, focusing on safe storage and early intervention. Gary Smith, MD, DrPH, the senior author, called for collaborations among educators, healthcare providers, and public health professionals to mitigate these incidents.
The study utilized data from the National Poison Data System (NPDS) maintained by America’s Poison Centers, which documents exposure calls made to the national Poison Help Line (1-800-222-1222). As part of ongoing public health efforts, resources for mental health and substance abuse assistance, including the 988 crisis line, are emphasized for individuals in need.