Atropine-type intoxication of children
Survey of participants in children's games
Author: L. TUGRUL
Pages: 75 to 78
Creation Date: 1985/01/01
In central Anatolia (Turkey), there is a popular children's game in which various parts of plants are eaten. In 1982 and 1983, a study was carried out involving 76 children who ate psychoactive henbane plants (of the Hyoscyamusspecies) during such games. The study showed that the majority of the children (81.6 per cent) ate henbane plants during their games to experience pleasant sensations or to try the effects of the plants. As a consequence of these games, 20 children, or 26.3 per cent of those included in the study, were severely intoxicated and brought in for treatment : five children were in a comatose state and two died. The article points out that the abuse of henbane plants is a dangerous form of drug abuse because it is easy to obtain these plants, large quantities of which grow wild in Turkey, and because parents are not aware of the hazards involved in children's games in which such psychoactive plants are eaten.
During 1982 and 1983, a first aid centre in central Anatolia registered 20 cases of atropine-type intoxication , which was manifested by mydriasis, disorders of consciousness and other signs and symptoms characteristic of such in toxication. Of those 20 cases, 11 were in the 6- to 9-year-old age group and 9 were in the 10- to 16-year-old age group. Two Children died soon after they were brought for treatment, and five were in a coma.
The atropine-type intoxication prompted the author to undertake toxicological examinations. For this purpose, samples were taken from the urine, blood and stomach contents (from a stomach washing) of the intoxicated children. The samples were subjected to botanical and laboratory analytical investigations. Parts of plants that were found in samples were examined under the microscope and compared with plants that were known to have atropine effects. Such plants were collected in the areas where the children had been in toxicated and in the Herbarium. This examination showed that parts of either Hyoscyamusniger Linné or Hyoscyamus reticulatus Linné, genera of the family Solanaceae, were present in samples taken from intoxicated children ; the former plant was identified in 11 cases and the latter in 9 cases. Laboratory analyses of samples, using thin layer chromatography and an in fra-red spectrophotometer, disclosed the presence of the alkaloids hyoscyamine and hyoscine (scopolamine). A TLC-fluorodensitometer was used for quantitative determination of the two alkaloids.
Laboratory analyses and botanical examinations of samples were corroborative and both supported the diagnoses of atropine-type intoxications that were based on the clinical picture.
Both in 1982 and 1983, intoxication occurred in the period from March to July, with a peak in May and June, which showed the typical seasonal character of the intoxication. This period of the year coincides with the appearance of vegetation of the species Hyoscyamus.
The interview with the intoxicated children, their parents and other informants showed that just before they became intoxicated the intoxicated children had taken part in a game which included the eating of various parts of plants. This kind of game is popular among children in central Anatolia.
The information about children's games prompted the author to undertake a survey of all children who had taken part in such games, regardless of whether they were brought in for treatment or not. The results of this survey showed that of 76 children interviewed who had taken part in the games in 1982 and 1983 , only 20, or 26.3 per cent, were brought in for treatment because of intoxication.
The survey also showed that of those 76 children, 18.4 per cent swallowed the psychoactive plants by accident, 65.8 per cent ate the plants to produce a pleasant experience, and 15.8 per cent ate henbane plants just to try them. Some children reported having eaten henbane plants several times when playing children's games.
A tropa belladonna, Datura stramonium and Hyoscyamus nigerare medicinal plants whose psychoactive properties have been known for centuries [ 1] - [ 3] . Some species of these plants grow wild in Turkey. Intoxication involving these plants usually occurs in one of the following ways :
The berries of Atropa belladonnaare eaten by accident;
The leaves of Datura stramonium are mistakenly collected and eaten as wild spinach ;
Plants of the Hyoscyamus species are eaten by children during a game in which children eat various parts of plants.
The main active elements of these plants are alkaloids - hyoscyamine and hyoscine - which are completely absorbed through the intestinal tract into the blood in two hours. Approximately 85 per cent of the consumed drug is excreted in the urine within 24 hours. These alkaloids can be detected and identified in body fluids using ordinary laboratory techniques [ 4] - [ 7] . Because of their psychoactive properties, solanaceous plants have been used in certain religious ceremonies and are often abused by children.
The abuse of henbane plants (of the Hyoscyamus species) by children is dangerous for the following reasons :
These plants are easy to find since they grow wild inabundant quantities ;
Parents usually do not know the hazards involved and are not aware of the underlying reasons for plant-eating games ;
After the diagnosis is made in a hospital, a case is usually registered as accidental atropine-type intoxication ;
The plant-eating game is generally considered by the public to be a harmless children's game, but it disguises a form of drug abuse by children that may have severe consequences.
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