New Jersey Pharmacists Against the Closing of New Jersey Poison Control

New Jersey pharmacists and the students of Ernest Mario School of Pharmacy recently became aware of a recommendation by your transition team to close the New Jersey Poison Information and Education System (NJPIES). We are urging that this suggestion not be followed.

NJPIES is a valuable resource for the pharmacists and the citizens of New Jersey that cannot be replaced. It provides a 24/7 hotline for pharmacists (and all health care professionals) and the citizens of New Jersey to call in case they, their patients, or their children are thought to have taken an overdose of a medication, accidentally ingested a chemical, been exposed to a product they think is harmful, etc. NJPIES handles about 80,000 calls a year from the citizens of this state. Both the pharmacists and lay public rely upon the services of NJPIES.

Despite the suggestion of the transition team, NJPIES service cannot be replaced by the internet. In an emergency situation, not all pharmacists will have access to an internet site that provides up-to-date poison information, nor will most pharmacists have references in their store that deal with management of poisoned patients.

It is not uncommon for a pharmacist to receive a phone call in their store from a frantic parent wanting to know what to do if their child took an overdose of medication, or if they or their child took the incorrect medication. In these situations, pharmacists will routinely check with the experts at the NJ Poison Center for the latest recommendation on how the patient should be handled or will have the patient contact the poison center directly. The specialists at the poison center provide insight and advice that is just not found on the internet or in textbooks.

The health professionals at the NJ Poison Center provide patient and situation specific advice; no canned responses are given. In addition, while pharmacists may be experts at drug therapy, they are generally not experts at poisonings from chemicals, carbon monoxide, heavy metals, toxic alcohols, etc. The NJPIES staff is specially trained in these cases and handles dozens of poisonings each day.

NJPIES is also a site where pharmacy students spend time learning about poison and drug information. Students spend anywhere from 1 day to 5 weeks working with the poison experts. If the poison center is closed, there will be no place to get the hands-on experience that students in other states currently receive.

With respect to the lay public, it is not reasonable to expect that a citizen can access the internet to determine if the product/plant/chemical at a specific dose ingested is harmful to their child or themselves. It is important to recognize that the validity of information on the internet is often in question. There is no requirement for any of the information on the internet to be accurate, scientifically-based, regularly reviewed or corrected. It is inherently dangerous to use the internet as a definitive reference, even for a health professional.

Lacking this vital resource, pharmacists will undoubtedly send the victim into an emergency room, often unnecessarily increasing the burden on emergency room staff. In an era of health care reform, every penny saved is important. A study conducted by NJPIES utilizing NJDHSS hospital utilization data suggests that, conservatively, the return on investment in NJPIES just on the cost of hospitalization in NJ for poisonings is over 10:1, that is for every $1 invested in poison control services there is a savings of over $10. This work duplicated other investigations both nationally and regionally in other states and localities. Based on your transition teams cost-saving incentive to close the poison center, the amount of money NJPIES saves the government far surpasses the amount spent.

Also, think of the other side: the victim not taken to an emergency room because the degree of potential toxicity is not recognized until too late. The potential loss of function or life could be staggering.

We believe that NJPIES is a necessary program that results in saving lives and significant amounts of health care funds. It would be short-sighted to close the center. As pharmacists, we would be devastated to continue our careers without this valuable source of information and help. For both pharmacists and our patients, we urge the legislature and governors office to reject the suggestion of the transition team.