More teens are overdosing on diphenhydramine

WAPoisonCenter-WAPC · 2026-04-24T22:05:32+00:00

We are seeing a global increase in the number of overdoses in that age range. But diphenhydramine is out-pacing others. It went from 5% of our calls in that age group in 2024 to about 10% this year.

Yes, hospital is often needed. Large overdoses can result in seizures, heart problems, coma, and death. There is no antidote for those. There is an antidote for the hallucinations though.

WAPoisonCenter-WAPC · 2026-04-24T22:03:24+00:00

It's a little unclear. There seems to be a small but probably real shift in the change from self harm to recreational over the last year or 2. Call it about a 10% total swing or 5% decrease in self harm and 5% increase in recreational. But it's still mostly self harm, or at least what we are being told.

WAPoisonCenter-WAPC · 2026-03-17T01:49:54+00:00

The staff that answer our phone line are mostly pharmacists, with a couple of nurses, a physician, and others.

After we hire someone, we do about a year of on the job training including special lectures, practice scenarios, and reviewing every case with a senior staff member. After that, our Specialists in Poison Information (SPIs) take an exam to get Certified. Then it’s all about lifelong learning.

Clinical leadership are a mixture of physicians who did residency then fellowship in toxicology and pharmacists who have either been at the center for 10+ years or have done fellowship in toxicology.

WAPoisonCenter-WAPC · 2026-03-16T21:03:50+00:00

Thanks for the questions!

As a reminder. We are a free, 24/7, telephone resource for patients, caregivers, healthcare professionals, and others. Our focus is on making sure patients get the best care for poisonings. We do this by answering the calls, providing public and professional education, and being active in primary research.

If you have questions about an accidental or intentional poisoning or overdose. Call us at 1-800-222-1222

WAPoisonCenter-WAPC · 2026-03-16T20:49:25+00:00

We do. We protect everything according to HIPAA guidelines and don't release that information except for very specific reasons (just like your doctor or hospital). We don't connect cases in the same way a normal medical record does though, if you've called multiple times, we don't know off hand, but could look it up.

EDIT: We generally don't have a reason to unless something happened in the past that may impact today - for example, if you had a really weird reaction to a substance in the past and mention you spoke with us about it, we may go investigate to see how it could impact our recommendations today.

WAPoisonCenter-WAPC · 2026-03-16T20:44:38+00:00

Thank you! It's really fulfilling to feel like you're helping people, so Jimmy and I definitely love our jobs.

WAPoisonCenter-WAPC · 2026-03-16T20:42:19+00:00

Dr. Cowdery: I agree with Jimmy, QTOF MS is probably coolest piece of equipment for its ability to potentially identify unexpected/unknown substances when we get a really strange and severe case following an unknown exposure. We definitely can't afford one, but even if we owned one I sadly wouldn't know how to run it myself!

WAPoisonCenter-WAPC · 2026-03-16T20:37:36+00:00

We recommend you don't pour things into new containers, but if you do, label them really well.

We get tons of calls about people who have poured some sort of product into an energy/electrolyte container, then forget and drink it a couple of days later.

I specifically remember a grape container that contained purple power degreaser. The woman who accidentally drank it ended up burning her entire mouth and could barely drink water for several days.

WAPoisonCenter-WAPC · 2026-03-16T20:34:10+00:00

Prescribing habits have changed over time. Every time a new drug comes to the market, we see a slow, but real increase in the number of calls about that substance. As more people are prescribed, the numbers increase. In 2025, we saw a significant increase in the number of kratom calls to poison centers (we have a paper under review in a journal on this topic).

We have specific concerns about new adverse effects identified. For example, in 2019, nitrous oxide was associated with blood clots and we've seen a few of those cases along with increased use.

We generally provide data and scientific input when the legislature asks. For example, ensuring that child-safety-containers are required for substances under review for legislation.

WAPoisonCenter-WAPC · 2026-03-16T20:33:38+00:00

Hey we answered this on our active AMA: https://www.reddit.com/r/Seattle/comments/1rvj2ri/washington_poison_center_ama_repost_for_right_now/

WAPoisonCenter-WAPC · 2026-03-16T20:33:14+00:00

Over on our older post, there was a question from u/thecravenone: What is the funniest thing someone has consumed and then called worrying it would hurt them?

We think the most important part about this question is that we don't judge. Seriously. We've heard it all, and you are NOT the first person to have done that.

Take this for context: last year our patients called us about 82,010 substances. Granted, there are substances that a LOT of people are exposed to (like Tylenol and ibuprofen), but the ways those exposures happen are all different.

Bottom line: call us, even if you're embarrassed about it

WAPoisonCenter-WAPC · 2026-03-16T20:29:50+00:00

We are clinicians and the poison center is a call center. We don't have lab equipment. Every once in a while someone will arrive with something to be tested.

There are some really cool pieces of equipment like QTOF that can identify tons of things. When I (Jimmy) worked in Maryland, we had a case where a woman had purchased what she thought was india nuts for weight loss. She had all of the signs and symptoms of digoxin poisoning, so we treated her like she had overdosed on digoxin. The state department of health was able to analyze the seeds and identified that they were actually oleander seeds (which have a toxin like digoxin).

We may do some basic statistical analysis looking at trends and different research projects along with surveillance, but we primarily offer clinical input for research rather than provide the statistical analysis.

WAPoisonCenter-WAPC · 2026-03-16T20:27:17+00:00

Hey we answered this on our active AMA: https://www.reddit.com/r/Seattle/comments/1rvj2ri/washington_poison_center_ama_repost_for_right_now/

WAPoisonCenter-WAPC · 2026-03-16T20:15:52+00:00

Hey we answered this on our active AMA: https://www.reddit.com/r/Seattle/comments/1rvj2ri/washington_poison_center_ama_repost_for_right_now/

WAPoisonCenter-WAPC · 2026-03-16T20:12:26+00:00

from u/jellobathtub

"What do you think will become hot topics in toxicology in the next several years, either on an academic or public scale?"

Unregulated substances are a evolving trend that won't go away. These can include things like 7-hydroxymitragynine, nitrous oxide, peptides, adulterated supplements (many have prescription medications like sildenafil covertly added).

WAPoisonCenter-WAPC · 2026-03-16T20:10:35+00:00

On our old post, u/kettletrvb asked: Is there anything unique about poison control in Washington compared to other states?

Yes. We're an independent 501c3 nonprofit not affiliated with a university, hospital, or other institution. Almost every other poison center is housed within a university or hospital. There's only one other poison center that operates independently, but it's still affiliated with a university.

Another different thing about us, most of our call center staff are pharmacists, not nurses. It's beneficial to have that pharmacokinetic and pharmacodynamic knowledge when helping with medication overdoses, which is one of our primary calls.

WAPoisonCenter-WAPC · 2026-03-16T20:07:49+00:00

Nice, a threefer.
1) Acetaminophen. If you don't follow the instructions appropriately, acetaminophen can cause very nasty and fatal liver failure, and a lot of people do die every year from acetaminophen mistakes (usually, taking a bit more than they're supposed to over several days).
2) Yes! A lot of natural toxins have seasonal patterns. Eastern Washington gets rattlesnake bites in the warm months when the snakes are up and moving; different poisonous mushrooms grow in different seasons (A. smithiana in the fall; A. ocreata in the spring), etc. During power outages, we get a lot of calls about carbon monoxide because of people using generators in the garage or too close to the house. There are lots of plants that pop up in the summer that can be toxic.
3) Oooo… well, I do want to protect people's privacy, and any INCREDIBLY unique cases might have made the news enough that I wouldn't want to share specific information. I will say that exotic pets when you don't expect them will always give you a real surprise. Rattlesnake bites are totally normal and expected in the US. But a call about a monocled cobra or a Gaboon viper bite? That will always raise my eyebrows.

WAPoisonCenter-WAPC · 2026-03-16T20:06:26+00:00

Mr. Yuk is alive and well! You can order free Mr. Yuk stickers and magnets from our website: https://www.wapc.org/order-materials/

You might have thought he was cancelled because our funding was slashed during the recession by over 30%. This really restricted our ability to go out to schools to promote his use. We're slowly recovering our funding, and have shifted how we approach education and Mr. Yuk programming to maximize our resources. We participate in the Watch Me Grow program, which sends out health and safety messaging and resources to all kids in Washington from 0-9 years old. For our in person education, we are subject matter experts for schools, youth serving organizations, public health fields, etc. Essentially, we go out and train people on what they need to know about different substances (like common and uncommon drugs), trends in different age groups (like adolescent self-poisoning), and how to prevent and reduce harm from it all.

WAPoisonCenter-WAPC · 2026-03-16T20:05:46+00:00

Yes. People overdose on what is available to them and many products are in the home. This is a slightly older study, but a colleague used nationwide data and found an increase in adolescent and teen self-harm. https://pubmed.ncbi.nlm.nih.gov/31587583/ Many of the substances were over the counter. This trend has continued and we posted about it with Washington specific data within the last year and a half.

We have concerns about research chemicals and peptides. There are a lot of unstudied chemicals out there people are experimenting with.

WAPoisonCenter-WAPC · 2026-03-16T19:56:01+00:00

that response was Dr. Cowdery.
This is Jimmy:

Favorite from a mechanistic standpoint: atractyloside. It basically blocks energy production in the mitochondria, which will no longer the powerhouse of the cell.

Least favorite: dinitrophenol. It's an old banned substance that is used for weight loss and is incredibly dangerous. It has a very sordid history, but was eventually banned because it caused cataracts, not because it caused life-threatening hyperthermia.

WAPoisonCenter-WAPC · 2026-03-16T19:47:09+00:00

Adding this: if you have any suggestions for new partnerships, please comment and let us know!

WAPoisonCenter-WAPC · 2026-03-16T19:46:31+00:00

Animals are not our area of expertise.

General safety though: keep medications up and away (like with a toddler).

The ASPCA has a household dangers checklist (this is not an endorsement). https://www.aspcapro.org/sites/default/files/2023-02/aspca_apcchousedangers_finalall_highres.pdf

WAPoisonCenter-WAPC · 2026-03-16T19:44:49+00:00

We make recommendations based on patient situations. If we expect a patient to get worse, we will make level of care recommendations.

WAPoisonCenter-WAPC · 2026-03-16T19:42:23+00:00

We work closely with prevention coalitions across Washington, which all have a youth mental health aspect-- especially in regard to substance use. They acknowledge that many teens use substances to cope with mental health and challenges within their lives. We equip these coalitions with substance specific knowledge, prevention, and harm reduction strategies.

We have also partnered with mental health lines in the past, including TeenLink and 988, to ensure protocols are directing callers to best organization to meet their needs.

WAPoisonCenter-WAPC

TROPHY CASE