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 second1 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 initiatives2 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/

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