Self-medication in childhood: Observations at a residential summer camp

Since the 1930s our society has experienced a marked increase in the consumption of medicines. Expenditure for medications has amounted to 10% to 15% of health care costs in both the United States and Europe, equivalent to 1% of the American Gross National Product.1 Per capita drug consumption in the United States is among the highest in the Western World and twice that in the British Isles.1,2 A large proportion of drugs consumed are self-prescribed, nonprescription medications accounting for 40% of the national expenditure on medicines.1 Surveys of large populations confirm the high rate of drug consumption; 30% of people questioned have used one or more nonprescription medications in the previous 48 hours.2,3 The use of nonprescription medications is not limited to adults. In surveys of large populations it has been shown that 30% to 50% of children have received medicines during a 48-hour recall period,4,5 and 75% received medicines during a 4-week period.5-7 Furthermore, 50% of mothers stock seven or more medicines for home use, and 30% report giving their children seven or more types of medicines during the course of a year.6,7 In the face of this extensive consumption of medicines little is known about the age at which children are given or assume responsibility for taking medications. A review of medical history forms for enrollment at a summer camp in 1990 revealed that 30% of campers aged 9 to 16 years intended to bring their own nonprescription medications to camp.8 This led us to suspect that American children may be given responsibility for self-medicating at an early age.