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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Sunday 11th March 2012

A story from New Zealand immediately caught my attention. Any doubt about the meaning of the headline ‘Babies and elderly suffering from 'poison' dope’ was immediately removed by the first sentence of the piece ‘Babies are swallowing cannabis left lying around by their parents, calls to the National Poisons Centre show’.

As soon as I read the words ‘Poisons Centre’ I start to wonder if this was going to be another story being selective about what it decides is important. That is what I found in the 2010 American Association of Poison Control Centers (AAPCC) Annual Report.

According to the, the New Zealand centre received 166 calls about adverse reactions to recreational drugs. My first response to that is to ask ‘166 of how many total calls’ and that sent me off to the New Zealand National Poisons Centre (NZNPC) website. The site publishes quarterly reports so I downloaded the four related to 2011 and combined them to get to annual figures.

The reports are more about performance of the centre rather than the poisons involved with lots of information about response rates and call lengths so the breakdown of the reasons for the calls is not that detailed. There are only thirteen categories of substances analysed so I assumed that ‘recreational drugs’ is part of the category reported as ‘Chemical/Drugs of Abuse’. A different table, Table G, analyses calls ‘by intent’ and has a category ‘Child exploratory’ that I would assume covers a child eating something it found lying around.

The total in the category ‘Chemical/Drugs of Abuse’ for 2011 comes to 367 calls so it is quite feasible that the 166 mentioned in the press are a sub-set of that total. Except. The press report goes on ‘Among them were calls about children and babies as young as eight months who had swallowed cannabis in their homes’. The monthly figures given in the four quarterly reports for 2011, however, are all zero for children aged 0-4 years. Where are these under ones who have been munching cannabis?

I emailed the NZNPC and received a prompt response saying that these types of cases would be classified as ‘Miscellaneous’ because the ‘Chemical/Drugs of Abuse’ ‘only records exposures where the intent of the exposure is abuse’. Yet, Table G supposedly breaks down calls into ‘Child exploratory’, ‘Unintentional’ and ‘Abuse/Misuse’ amongst others.

The age breakdown in Table H brings up another interesting point. Since the centre collects age data, and even records the number of calls where the age wasn’t established, why does the report say ‘among them’ rather than setting out exactly how many of the 166 calls were related to children. Instead the press account says; ‘The centre would not release details on what regions the children were from or the specific number of cases’. Why not?

Last Wednesday 7th I wrote about the way Matt Baker on BBC’s Countryfile used ‘legend has it’ as a way of avoiding having to say whether or not there were 99 yew trees in St Mary’s churchyard in Painswick. It strikes me that not releasing details is a way of not having to cite how few cases there actually were.

The email from NZNPC is interesting on this point. It says; ‘the journalist contacted the poison centre and asked how many exposures had occurred for a specific substance and for these types of media requests we can provide more detailed information’. Yet, that more detailed information didn’t, apparently, include the actual number of cases.

I know that there aren’t that many because lower down in the piece it says; ‘A total of 25 calls were made regarding cannabis last year’. So, something less than 25 calls may have had to do with children eating cannabis left lying around but there is no way to determine the actual number. Certainly, given that there is reference to adults having problems as a result of getting higher-strength cannabis than they were used to, not all of the 25 calls are to do with children.

But, let’s suppose they were. That compares to 5,731 calls related to therapeutic substances and 4,950 related to household items all from a total of 14,708 calls about children under 14 out of the centre’s 21,481 total calls.

Even the 1049 calls related to plants and 232 calls related to fungi make the 25 related to cannabis seem insignificant.

The quarterly reports give a monthly breakdown for the substances included in the heading ‘Therapeutics’. In December alone, analgesics, anti-infectives, anti-inflammatories, supplements and topical applications all recorded higher figures for one month than cannabis did for the whole year. Similarly, under the ‘Household’ category, cleaner, detergent and disinfectant all recorded higher totals in one month than the 25 cannabis calls in a year quoted in the news report.

I’m left to wonder what the point of this story was. If the intention had been to warn parents about the dangers of leaving things around for children to ingest, it would have been much better to focus on the substances that are doing the bulk of the harm, such as picking out the 849 calls related to children and analgesics in the year. Especially, since only around 15% of New Zealand adults are cannabis users whereas almost everybody has analgesics in the home. Campaigning about the dangers of accidental analgesic ingestion would, surely, produce greater benefit.

Incidentally, that prevalence issue can be very roughly accounted for. If cannabis were in every home, the 25 calls that were the result of it goes to just over 150 or around one fifth of those resulting from painkillers being left where children can reach them.

If not to try and do some good to the public health then, perhaps, the story was just an attempt to stigmatise cannabis using parents whilst ignoring the far greater number of parents who put their children at far greater risk by leaving seriously harmful pharmaceuticals lying around. Given that it seems the story began with interest from the journalist rather than action by the NZNPC that appears likely.

When you look into the numbers it begins to seem that this is just another example of using partial information to try and demonise drug users.