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Are your children self-medicating with pain-killers?

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Children often mimic their parents’ behaviors, both good and bad. A new study has found that the children of mothers who self-medicate with over-the-counter-pain killers often self-medicate with those pain killers. The study was published online on January 6 in the journal Pediatrics by researchers at the Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen (Copenhagen, Denmark) and the National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark (Copenhagen, Denmark).
The most common over-the-counter pain-killer associated with self-medication by mothers and children was paracetamol, which is known as acetaminophen (Tylenol and generic equivalents) in the United States.

The researchers note that self-medication with over-the-counter pain-killers such as paracetamol among children and teens is on the increase in many nations and is currently a major public health issue. The reasons for this increase are unclear at present; however, many researchers believe that it is due to parental influence. The objective of their study was to evaluate whether self-medication with over-the-counter pain-killers among school-aged children is influenced by their mothers’ self-reported health and medicine use; the investigators factored in the child’s pain frequency into account, meaning, they adjusted for actual pain episodes experienced by the child.

The study group comprised 131 children aged 6 to 11 years and their mothers who were enrolled in the Demonstration Of A Study To Coordinate And Perform Human Biomonitoring On A European Scale (DEMOCOPHES) European project. The subjects were selected from one urban and one rural area of Denmark, and equally distributed in age and gender between the two locations. The children were assessed via a structured interview and their mothers filled out questionnaires in regard to mothers regarding health, pain, and medicine use.

The researchers found that maternal use of over-the-counter pain-killers was significantly related to their children’s self-medication of these drugs. The association held up after adjusting for several sociodemographic and health parameters. After adjusting for the child’s pain, the association was particularly strong with paracetamol (acetaminophen); children of mother’s who self-medicated with the drug were three times more likely to self-medicate with it. In addition, the researchers did not find a clear association with a child’s pain and the use of over-the-counter pain killers. Furthermore, maternal health (self-assessed health, chronic pain, chronic disease, or daily medicine intake) did not significantly influence their child’s use of over-the-counter pain-killers.

The authors concluded that maternal self-medication with over-the-counter pain-killers is associated with self-medication of over-the-counter pain-killers, predominantly paracetamol (acetaminophen), among school-aged children, perhaps to a greater degree than the child’s actual pain. In addition, maternal health appeared to be of lesser importance. They recommended that parents of school age children should be informed regarding about pain self-management because this would promote appropriate use of over-the-counter pain killers among schoolchildren.

Take home message:
Children who self-medicate with acetaminophen not uncommonly overdose. The drug has an excellent safety profile when administered in proper therapeutic doses; however, liver damage can occur with misuse and overdose. In the US, acetaminophen toxicity has replaced viral hepatitis as the most common cause of acute hepatic (liver) failure and is the second most common cause of liver failure requiring transplantation.