That means that, the CDC’s safety initiative notwithstanding, melatonin’s packaging doesn’t have to be child resistant. Supplements are regulated by the FDA more as foods than as medications. Babies don’t know what they’re eating and often put random stuff in their mouth slightly older kids, such as the ones who have been taking too much melatonin, may be more likely to mistake gummies for candy. Maribeth Lovegrove, the researcher who led the CDC research, told me that for most medications, pediatric overdoses are concentrated among children under 2 years old. Nearly all of the patients Toce saw had eaten gummies, and most of those identified in the CDC’s emergency-room study were 3 to 5 years old. It’s an active hormone, and the body has not developed great mechanisms for coping with its intake in excess, Cohen said. So do all sorts of vitamins and minerals for kids-vitamin A, vitamin C, calcium, zinc-but melatonin is not a vitamin or a mineral. For starters, many melatonin supplements come in an appetizing gummy form. Several other factors would also seem to be involved, Cohen told me. Whether they account for all of the surge or most of it or merely some of it remains a mystery. Those changes in demand are “definitely a factor” in the associated surge in overdoses, says Pieter Cohen, a doctor and supplements expert at Cambridge Health Alliance, in Somerville, Massachusetts. It’s possible that melatonin overdoses are rarer now than they would have been without the CDC’s safety initiative, but are still increasing on account of the supplement’s overall success in the marketplace. It promoted the widespread adoption of flow restrictors and child-resistant packaging, and ran campaigns to educate parents about medication safety and storage. The year before melatonin usage began to rise, the CDC launched an initiative to reduce pediatric overdoses as a whole. A pandemic-era surge in diagnosed sleep disorders may have only accelerated this growing popularity. sales of the supplement rose from $285 million to $821 million. ![]() From 2009 to 2018, American melatonin use increased fivefold, and from 2016 to 2020, U.S. The most obvious answer is its recent surge in popularity. The question is: What sets melatonin apart? Meanwhile, the overdose numbers for other substances plummeted during the 2010s: Tylenol, down 53 percent opioids, down 54 percent many cough and cold medications, down 72 percent. Just last month, in a broader study based on emergency-room data over a similar period, researchers at the CDC reported a 420 percent increase in visits for pediatric melatonin ingestions. By 2020, poison control was receiving more calls about pediatric overdoses on melatonin than on any other substance. Over the prior 10 years, the number of annual calls to poison control for pediatric melatonin overdoses had risen by 530 percent. Their findings, published last June, were striking. ![]() In 2022, a group in Michigan invited Toce to collaborate on a study of the phenomenon. Other doctors around the country were observing something similar. The ill effects of this mistake seemed mild at the worst-drowsiness, nausea, vomiting-but the number of kids who were affected was going up, up, up. Instead, they’d swallowed too much melatonin, an over-the-counter supplement used as a sleep aid. The problem wasn’t that they’d overdosed on opioids or painkillers or marijuana. As a pediatric-emergency-medicine doctor at Boston Children’s Hospital, he was seeing lots of kids who had taken too much medication. In the dark, early days of the coronavirus pandemic, Michael Toce noticed a surprising trend.
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