Research In Action

Every single day, experts at the Poison Control Center at CHOP help inform healthcare professionals providing medical care to adolescents and adults who have attempted suicide using chemicals or drugs. 

One of the most important steps families can take during recovery is to make the home environment safer by limiting access to medications that could be used in another “overdose.” It may be under-appreciated that between 1/4 and 1/3 of adolescents who attempt suicide by drug “overdose” will attempt it again, with the highest risk in the first year following the initial attempt. The concept of lethal means restriction applies to poisoning prevention, too. 

The scope of suicide prevention is large. In 2022, we presented our data at the Pediatric Academic Societies meeting showing that poison-related suicide attempts among children in PA and DE were rising, and that 10% of these cases involved young children aged 6-12 years. In 2025, Pennsylvania’s two poison centers recorded 2,724 cases, from PA or DE, of intentional drug overdose among children and teenagers aged 6 to 19 years. Prescription antidepressants and over-the-counter pain relievers were the most implicated drugs, and poisonings with exotic chemicals or requiring treatment with rare antidotes were noted, too. Each suicide attempt is an important reminder to make the home environment safter by limiting access to medications or household products that could be used in another overdose. 

Figure: Attempted Suicide Cases Among Children and Teenagers from PA and DE in 2025, as Reported to PA’s Poison Centers 

Our CHOP Division of Emergency Medicine colleagues have recently published important guidance in lethal means counseling. 

• Suicide Prevention in Pediatric Health Care Settings 
• Youth Suicide Prevention in the Emergency Department: Lethal Means Counseling 101 

We share these important tips to try to promote safer home environments after intentional drug overdose: 

1. Remember that guns remain the most lethal means of suicide! If any firearms are staying present at home, they need to be locked and unloaded.  
2. The medical team should review all actively prescribed medicines and consider their necessity, their potential adverse effect profile, and their risk of harm in overdose, and they should strive for the lowest effective dose for the shortest necessary period. Avoid prescribing or dispensing in 90-day-supplies. 
3. Encourage families to inventory prescription medications, over-the-counter medications, and chemical products within the home, and to properly dispose of unneeded products. Talk to visitors, friends, and family about medication safety too. Our poison center offers CHOP patients this “Be Safe” medication disposal guide.  
4. Create a home medication storage, supervision, and dispensing safety plan individualized to each family. 
   • Identify a safe medication storage site. Strongly consider a lock box. 
   • As a temporary precaution, one responsible adult should control and dispense necessary medications. 
   • As recovery progresses, increasing autonomy can be returned as agreed among the family and the medical treatment team. 
5. If opioid pain relievers, or individuals with opioid use disorder, are in the home, recommend naloxone nasal spray for the home (see guidance for PA and DE). The Poison Control Center at CHOP also provides an excellent resource about naloxone available in multiple languages. 

If you have questions about medication safety, please call the Children’s Hospital of Philadelphia (or your own regional) Poison Help Hotline at 1-800-222-1222 to be connected to a specialist. If a person is having trouble breathing or loss of consciousness call 911. The national Suicide & Crisis Lifeline can be reached by dialing 988.