A couple of months ago, 88-year-old Edna brought all of her medicine bottles home for me to review. Lifting each medicine out of the shoe box, I noticed how faded the red lettering was on the white plastic child-resistant caps. Some of her drugs had lids sitting crooked or were barely fastened, and one label was nearly 5 years old despite having newly refilled pills inside.
Edna’s struggle with child-resistant tops is not limited to just her medicines. Many other everyday household products are sold with hard-to-open lids: paint thinner, cleaning solutions, bleach, vinegar, vitamins, and liquid over-the-counter (OTC) medicines like cough syrup.
The widespread use of child-resistant lids addresses a serious problem: accidental child poisonings.
In the 1960s, the most frequently documented cause of injury in children under 5 years old was accidentally swallowing medicines or household cleaners. In 1970 the United States Congress passed the Poison Prevention Packaging Act (PPPA), which required all prescription and non-prescription drugs able to be swallowed to have child-resistant (C-R) packaging.
In the decades since, C-R packaging has saved many young lives but has also caused significant inconvenience for many adults, especially those with below-average strength and skill,ironically the ones who usually take the most medicines.
Since 1974, pharmacists have been required to dispense all medication refills in brand new vials and lids. As the caps on plastic medicine bottles get used, they get more comfortable to open and eventually won’t be able to meet the C-R standard.
Pharmacists must dispense all medicines with C-R lids EXCEPT for bottles of under-the-tongue tablets of nitroglycerin unless the patient requests otherwise in writing and signs it.
A lid is considered child-resistant if a child under 5 years old cannot open it within 5 minutes, but 90% of adults can open it within 5 minutes. Who wants to fight with a lid to get it to open and close? No wonder Bertha re-used her prescription bottles that had worn-out tops!
28 years ago,I ripped a ligament in my right wrist, putting me in a hard cast for 6 weeks and a rigid brace for another6 weeks. This was a significant handicap for me because I could NOT get child-resistant lids open wearing that cast or brace. As a pharmacist, I needed to open a LOT of child-resistant caps every day at work.
Desperate, I worked out a way to open those tricky caps without moving my wrist. I’m still using that technique today, because it helps me open child-resistant tops without straining my hands or wrists.
Here’s How I Open Child-Resistant Lids Without Using My Wrist:
- Pick up the bottle in your right hand.
Place the palm of your left-hand FLAT against the cap so that your hands form a sideways “T.” Your left hand is turned with your thumb pointing up, and your right hand is perpendicular to it as if your left hand was a door, and you are reaching for the doorknob with your right hand.
- PUSH both hands together with your arms until the lid is free.
As you push, be sure to keep your wrists straight. As the cap in your left-hand pushes up against your left palm (the top of the T), TURN your entire forearm just a little bit until you feel the bottle moves up into the white cap, freeing it to turn easily. You usually have to turn your right arm just a bit to the right to get the bottle into a position to push up into the cap.
- TWIST your forearm clockwise, like turning a doorknob.
TWIST your entire right forearm slowly clockwise, just like turning a doorknob. Make sure you move your whole forearm INSTEAD of twisting just your wrist. The pressure of your hands pushing toward each other keeps the outer cap free as your right arm turns.
- Separate your hands.
When you feel the cap come free, move the vial so the lid is up, cup the outer cap with your left palm, separate your hands, hold the top, and contain the vial. It’s open!
- Reverse the steps to put the lid back on.
To put the top back on, reverse the order of the steps: form a T with your hands, push your hands together, then turn your right forearm to the LEFT (counterclockwise) until the cap engages.
Remember, you can request “easy-open” lids for medicines at your pharmacy by requesting and signing a release form. Please remember to always store ALL medication away from children.
