ST. LOUIS — St. Louis Children’s Hospital will provide 1,000 free boxes over the next year to patients at risk of suicide or poisoning, a growing number of children in Missouri.

The boxes are large enough to hold several containers of medicine or a pistol. Only those who have the key to the padlock can open it.

Families who come to the emergency department with a child experiencing a mental health crisis or accidental poisoning will be offered a safety box, health officials said.

“A locked box can be crucial to protecting older children who may impulsively take medications as a form of self-harm or by accident,” said Dr. Lindsay Clukies, an emergency medicine physician at Washington University in St. Louis Children’s Hospital.

The boxes are provided free of charge thanks to a grant from the St. Louis Department of Health.

Missouri has seen an alarming increase in poisoning deaths among children under the age of 18 in recent years, according to the latest Missouri Child Mortality Report.

In the seven years before 2020, there were an average of 11 poisoning deaths per year. In 2022, that number rose to 62 — more than fourfold.

Of those 62 poisoning deaths, 43 were ruled accidental and the rest intentional. The synthetic opioid fentanyl was involved in many of the deaths, the report found.

Fentanyl is prescribed as a painkiller in the form of a shot, pill, powder, lozenge or patch. It is more potent than morphine, and even the smallest adult dose is enough to kill a child, Clukies said. Prescription brand names for fentanyl include Actiq, Duragesic and Sublimaze. Many illegal opioids can also be mixed with fentanyl.

Child suicides also increased between 2020 and 2022, from 35 to 42. Of these 42 suicides, 25 were caused by firearms and four by poisoning.

“This is unacceptable,” said Dr. Mati Hlatshwayo Davis, St. Louis County Health Director. “We are pleased to partner with St. Louis Children’s Hospital to provide parents with another way to keep their children safe while preventing unnecessary injuries and deaths.”

The lockboxes come on the heels of a program that St. Louis Children’s Hospital’s emergency department launched in 2020 to provide families with free gun locks. The program has since expanded to 20 locations across the BJC HealthCare system.

Health officials say there is hope the locker program will be a success and will be expanded.

Clukies also encouraged families to educate themselves about poisoning prevention, overdose symptoms and what to do in an emergency.

Children die from fentanyl because the drug slows and eventually stops their breathing. Symptoms of fentanyl ingestion have included drowsiness, loss of consciousness, confusion, difficulty breathing and constricted pupils.

Clukies said that in addition to immediately calling 911, another safety measure is to keep Narcan, a nasal spray that works quickly to reverse an opioid overdose, in the home. It can be used on children and adults.

Clukies encourages giving Narcan if there’s any suspicion of exposure — even if your child isn’t showing symptoms. “Symptoms develop so quickly, and in children, it only takes such a small dose to cause significant problems and respiratory failure,” she said.

In addition to keeping medications locked away at home, be aware of what medications and supplements are in the homes of family and friends and how they are stored. The Clukies admit that these conversations can be uncomfortable, but they are important in preventing exposure. A neutral and unbiased tone helps.

Finally, get rid of all your old medications. These items can be dropped off at any drug take-back location listed on the US Food and Drug Administration website.