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Saturday, March 14, 2015

Mortality higher in patients with ADHD: Accidental deaths blamed

A recent study in the Lancet showed that people with ADHD are most likely to die from accidents, and that the rate of accidents is elevated even if you take away interfering factors such as oppositional defiant disorder and substance abuse.   Adult women seemed to be at highest risk for accidental death.

Accidents are unavoidable in many cases.  However, when we see that a disease places us at higher risk, we have to ask if there is anything we can do to prevent more accidents from occurring.  How could ADHD place people at higher risk for accidental death?

The most important causes of accidental death are motor vehicle accidents and poisoning.  

People with ADHD are at higher risk for motor vehicle accidents for two important reasons.  One is inattention to the road.  The second is impulsive driving habits.  There are three things that we know can help lower the risk of death.
1)  Medication lowers the risk of automobile accidents in teens with ADHD.  Although the decision to use medication is a complex one, impulsive driving habits or inattention to the road are serious issues that need to be fixed soon for the safety of yourself and others.
2)  Seat belts save lives but don't change your risk of having an accident.
3)  Turning your cell phone off or having it in a mode where you are not tempted to text or answer the phone while you are driving also helps.

Another issue that can be a big problem for adult women drivers is driving with children.  It is very important to learn to pull over if you need to deal with your child's needs, or if you need to discipline your child.  

Poisoning includes all kinds of poisoning deaths except for suicides.  Accidental overdose of medications such as opiates are a big player here.  People with ADHD are prone to substance abuse, but even among those without an active substance abuse problem may have a higher risk of poisoning.  This might be due to patients impulsively taking more medication thinking "more is better", or due to forgetting and taking another dose when it wasn't needed.   It could also be due, in part, to mixing other medications with ADHD medications.  To reduce your risk of poisoning you can:
1)  Never mix your medications unless you know for sure it is safe.   Ask your doctor or pharmacist if you are unsure.  Better safe than sorry!
2)  Don't take medications that are not yours, especially prescription medications.
3)  Always ask your doctor how much pain medication you are allowed to take and never take more than is prescribed.   If your pain control is not adequate, try other methods, such as exercise, relaxation techniques, and counseling to try to manage your pain.   Ask your doctor for a referral to a pain management specialist to get started.  If you cannot control how much you take, it is better to be in pain than to die of overdose.
4)  Keep your medicines in a locked cabinet.  Put them in a pill minder box with the days of the week on it so that you know if you have taken your medication or not.
5)  Keep the number for poison control near your phone.

Other common ways adults can be poisoned include using household or automotive products or pesticides in an incorrect way.  Patients with ADHD may be less inclined to take the time to read directions or to take the time to purchase or locate personal protective equipment.  If you find you don't take the time to keep yourself safe consider the following actions:
1)  Keep personal protective equipment in several places in the house, near the hazardous substances.
2)  Minimize the use of toxic chemicals in your environment.   For example, there may be natural alternatives to pesticides or household cleaners.
3)  Ask a professional to handle toxic chemicals instead of doing it yourself.  Although a professional exterminator may be expensive, it may be well worth your while if you prevent yourself from being poisoned.


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