(CNN) Parents and grandparents, listen up -- this is serious. More than half of children under age five poisoned by prescription pills ate them after an adult removed the child-resistant safety packaging.
These medications include those to treat diabetes or cardiac conditions, which are hazardous to children even in small doses.
That's the disturbing findings from a new study, published Wednesday in the Journal of Pediatrics, that analyzed the reasons behind 4,496 calls to five poison centers in Arizona, Florida and Georgia over an eight-month period in 2017.
The study found that as caregivers take their meds out of tough-to-open containers and put them in easy reach places for convenience, they are inadvertently contributing to some 50,000 emergency room visits by kids every year who swallow dangerous pills when adults aren't paying attention.
"These data suggest it may be time to place greater emphasis on encouraging adults to keep medicines in containers with child-resistant features," said study author Dr. Daniel Budnitz, of the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention.
The CDC partnered with Atlanta's Emory University School of Medicine and the Georgia Poison Center to do the analysis.
Parents and grandparents are most likely to do one or more of the following things that allow kids access to potentially dangerous medications, the study found:
Child-resistant packaging is a major public health success. When the Poison Prevention Packaging Act was passed in 1970, childhood deaths from unintentional medication poisonings dropped dramatically.
But in the 2000s prescription use in the US rose, driven by factors such as an increase in the use of statins, antidepressants, asthma and diabetes medications, as well as a nation increasingly addicted to opioids.
As the pill-popping increased, so did the numbers of accidental ingestions by children.
In 2010, for example, there were 540,000 calls to US poison control centers from adults worried about a child who swallowed pills; in the same year there were approximately 75,000 emergency department visits, the study said.
Research shows that 70% of emergency department visits for unsupervised medication exposures in young children are because they have taken pills, or what science calls "solid dose medications."
But how do the kids get the pills? Is child-resistant packaging not working, or is there something else at play?
To find out, researchers trained workers at five poison control centers to ask specific questions of caregivers worried about children who had swallowed solid pills without their knowledge. Liquids, gums and lozenges were excluded, as were pills that were crushed to mix with food.
The survey found that in a third of all calls, the child was able to get the medication because it had been removed from the original container or packaging. But what was done by adults with those pills differed depending on the type of medication.
Diabetes and cardiac medications, for example, were more likely to be put into pill organizers or baggies, while ADHD medications and opioids were more likely to be found outside of any container, the study found.
"Nonprescription medications were most often accessed from the original containers, but for many of these medications, child-resistant packaging is not required because of low potential for toxicity," said the CDC in a statement.
"There is an opportunity here for innovating medication container options that promote adult adherence and provide portability and convenience, while maintaining child safety," Budnitz said.
It's best to keep medications in the original child-resistant packaging. However, if you have to remove them, the CDC suggests the following precautions: