No need to hurl the little brown bottle. But child safety advocates say parents no longer need to stock ipecac syrup — that tried-and-true vomit inducer — in their medicine cabinet.
It's just not effective in poisoning prevention, said Barbara Insley Crouch, a pharmacist and director of the Utah Poison Control Center. "We don't want people to panic over this," she said. "But we do want people to call us or their doctor first before they start their own first aid."
The American Academy of Pediatrics announced Monday that ipecac syrup should no longer be used routinely as a poison treatment intervention in the home.
The Utah Poison Control Center, most physicians and poison centers nationwide have recommended a dose of ipecac syrup for childhood poisonings for decades.
But the pediatric association scrapped those recommendations Monday, stating they were "based on a lack of clear benefit about the tincture's benefit, and the risk of people abusing the product."
Local experts say a new crop of people is using the "emetic" for unhealthy purposes — most notably, people who want to induce vomiting as part of a whole spectrum of eating disorders.
"Teenagers have access to it and may be using it for purging. That's another one of the side concerns," said Dr. Jeff Schunk, who treats children who've consumed poison in the emergency room at Primary Children's Medical Center in Salt Lake City.
"Why have it around when it could be abused?"
Ipecac syrup is extracted from a plant — the ipecacuanha scrub — found in Brazil. It works by stimulating the central nervous system and the stomach, causing the user to vomit.
Rader Programs, based in California, is one of the nation's large providers of information and treatment for all eating disorders including anorexia and bulimia. "The misuse of Ipecac syrup can cause significant and severe medical complications and even result in death," according to information on the group's Web site.
Karen Carpenter, the recording artist, suffered from an eating disorder and died from the misuse of ipecac syrup, according to Radar Programs.
There are circumstances when ipecac syrup is abused by teenagers who are bulimic, Crouch said. Even people who suffer from Munchausen's syndrome by proxy, a parenting disorder where parents fabricate medical symptoms in their children, have used ipecac on their kids.
But mostly, it's simply not proven that taking ipecac is necessary in most cases, Crouch said. Anyone who suspects poisoning should call the poison center first, 1-800-222-1222.
Most poisonings happen at home, but education and safety have increased in the past 20 years. "Most kids don't get into large amounts of substances," she said.
A number of factors make households more resistant to poisonings than in earlier years, and the majority of incidents are handled over the phone. "The biggest help has come through packaging," said Schunk.
"The frustrating tops to the containers . . . and there have been pretty big changes in amounts that are packaged," Schunk said. "Used to be they would give you no-safety-cap bottles with thousands of pills. They don't do that anymore. And public education has really improved."
Kids younger than age 6 — "oral explorers" as they are called by experts — are generally poisoned by one of five types of household ingredients. These include cleaners and bleaches, pain medication like fever reducers for children, perfumes and colognes, cough and cold syrups with their bright-colored bottles and house plants.
The "new scourge" in the world of poisons accessible to children is the powerful blood pressure and heart medication now on the market. Schunk said these "one-pill-can-kill" medications set up a dangerous scenario in which a toddler could get hold of a pill at a grandparent's house that hasn't been "child-proofed" for a long time.
But in 34,095 calls to the poison center this year, staff has only advised using ipecac 146 times.
"It's now recommended by the poison centers infrequently," Schunk said. "I think given the fact it makes kids vomit, and the benefits are uncertain, it's wise."
And vomiting doesn't empty the stomach very effectively anyway, Schunk said. "Ipecac really had its time, but it's gone now."
E-MAIL: lucy@desnews.com