New Study Reveals Alarming Rise in Intentional Substance Exposures in Schools

A new study published in the American Journal of Emergency Medicine by researchers at the Center for Injury Research and Policy of the Abigail Wexner Research Institute at Nationwide Children’s Hospital and the Central Ohio Poison Center has brought to light a concerning trend: a substantial increase in intentional substance exposures at school among elementary- and middle-school-aged children. This vital research, spanning from 2000 through 2024, offers critical insights for parents, educators, and healthcare professionals dedicated to safeguarding children and adolescents.

Nationwide Children's Hospital, recognized as one of America's largest not-for-profit free-standing pediatric health care systems, consistently leads with innovative research and comprehensive care. Their commitment to improving child health outcomes is evident in this impactful study, which provides a roadmap for understanding and addressing a complex issue affecting young people in educational settings.

Understanding the Rising Rates: What the Study Found

According to the researchers, the overall rate of reported intentional substance exposures at school saw a significant increase of 77.5% from 2000 to 2024. Delving deeper into the age groups, the increase was particularly stark among younger children:

• For elementary-school-aged children (6-10 years), the rate surged by 287%, from 3.1 to 11.9 reports per 100,000 children.
• Middle-school-aged children (11-13 years) experienced a 112% increase, from 10 to 21.3 per 100,000 children.

Conversely, the study found a slight decrease of 4% in the rate among high-school-aged children over the same period. However, high schoolers still accounted for nearly half (46%) of all intentional substance exposures at school and continued to experience the highest rates of serious medical outcomes and hospital admissions.

Dr. Hannah Hays, co-author of the study and medical director of the Central Ohio Poison Center, highlighted a crucial shift: “By about 2015, the reported exposure rate among middle-school-aged children had surpassed that among high-school-aged youth.” This finding, she noted, underscores the need for prevention efforts to begin earlier, while ensuring older adolescents have ready access to clinical and mental health support.

Diverse Substances, Varied Risks

The study also identified differences in the leading substance categories by age group, which is crucial for developing targeted prevention education:

• Elementary school (6–10 years): Cosmetics/personal care products (15%), arts/crafts/office supplies (15%), plants (15%), and foreign bodies/toys/miscellaneous (14%).
• Middle school (11–13 years): Cosmetics/personal care products (13%), arts/crafts/office supplies (11%), foreign bodies/toys/miscellaneous (8%), and analgesics (8%).
• High school (14–18 years): Analgesics (15%), stimulants and street drugs (12%), sedative/hypnotic/antipsychotic medications (10%), and cough and cold preparations (9%).

More than half of these intentional exposures were attributed to intentional misuse (62%), followed by abuse (24%) and suspected self-harm or suicidal intent (14%). The researchers clarified that “intentional misuse” refers to improper use for reasons other than seeking a high, while “abuse” specifically involves recreational use with the intent of seeking a psychotropic effect. Substance abuse and suspected self-harm were significantly more likely to be associated with serious medical outcomes.

For high school students, pharmaceutical exposures were linked to substantially greater clinical severity. Across all age groups, exposures involving pharmaceuticals were about 10 times more likely to result in a serious medical outcome and 14 times more likely to require admission to a non-critical or critical care unit compared to non-pharmaceutical exposures.

What This Means for Parents, Teachers, and Students

The findings from Nationwide Children's Hospital emphasize the critical need for age-specific prevention interventions and robust clinical response strategies. For parents, this means ensuring safe storage of medications and household products not only at home but also discussing these risks with children as they spend more time in school settings. Open communication about the dangers of intentional misuse and abuse is paramount.

For educators, this study highlights the importance of integrating substance use education and mental health screening into school programs from an earlier age. Collaboration among school officials, clinicians, poison centers, and public health professionals is vital to reducing these incidents, especially those linked to self-harm and substance abuse.

Students themselves can benefit from increased awareness and access to reliable information. Understanding the risks associated with different substances and knowing where to turn for help are crucial life skills. Tools like COSMIQ, a free voice-driven AI tutor, can support students in understanding complex health topics or preparing for tests, ensuring they have access to educational resources that empower them to make informed decisions about their well-being.

Moving Forward: A Call to Action

Dr. Gary Smith, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children’s, underscored the urgency: “The increasing rate of reported intentional substance exposures at school among elementary school- and middle school-aged children, combined with the greater severity observed among high school-aged children, underscores the need for targeted and coordinated prevention and early identification strategies that integrate substance use education and mental health screening and intervention.”

Nationwide Children's Hospital's dedication to this research provides invaluable data that can guide policy, education, and support systems. Their work, alongside that of the Central Ohio Poison Center and the Abigail Wexner Research Institute, exemplifies a proactive approach to addressing pressing child health challenges.

As a reminder, the national Poison Help Line number (1-800-222-1222) offers free, confidential advice from experts 24 hours a day, seven days a week. It's a vital resource for families to have readily available. Additionally, for anyone struggling or in crisis, the 988 Suicide & Crisis Lifeline provides 24/7 judgment-free support for mental health, substance use, and more via text, call, or chat.

By working together—parents, educators, healthcare providers, and community organizations—we can create safer environments and provide the necessary support for children and adolescents to thrive.