A Nationwide Children’s Hospital analysis of U.S. poison-center calls, released 28 September 2026, found that intentional substance exposures reported from school rose 77.5% between 2000 and 2024. The steepest climb is no longer only in high school. Elementary-age rates rose 287%; middle-school rates rose 112%.
Researchers at the Center for Injury Research and Policy and the Central Ohio Poison Center reviewed National Poison Data System records. Across 25 years they counted 122,700 intentional exposures among children 6–18 that happened at school. Most involved a single substance. Most did not end in a hospital stay. High-school students still account for the largest share of serious outcomes and admissions.
What “intentional” means here
Poison centers code “intentional” when a child took a substance on purpose — misuse, abuse, or a self-harm attempt — not when a first-grader swallowed a tablet by accident. The dataset cannot sort those motives cleanly. It also only captures events someone called about.
What changed
Rates per 100,000 children 6–18 went from 7.5 in 2000 to 13.3 in 2024. There was a sharp drop in 2020–2021 when schools closed, then a rebound. Elementary reports moved from 3.1 to 11.9 per 100,000. Middle-school reports moved from 10.0 to 21.3. Boys were 56.7% of the cases. About 5.3% of reports led to a non-critical or critical-care admission.
Competing readings
One view treats the numbers as a real behavioral shift — easier access to pills, vapes, and cannabis products. Another treats them as a surveillance artifact: more school nurse protocols and more willingness to call Poison Help. Both can be true. The 2020 collapse during remote school is hard to explain as just better reporting.
What parents can do this week
- Ask the school what it does when a student is found with pills or a vape.
- Lock prescription medicines at home.
- Save Poison Help: 1-800-222-1222.
- Watch for sudden drowsiness, vomiting, or unusual behavior after the school day.
What to watch next
Whether 2025–26 school incident counts match the poison-center curve, and whether elementary schools add the locked-medicine rules already common in high schools.
Source: Nationwide Children’s / Central Ohio Poison Center analysis of NPDS, 28 September 2026; American Journal of Emergency Medicine.
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