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Texas Poison Center Network

NOTE: Individuals requiring assistance with a potential poisoning or drug identification should contact their local poison center at 1-800-222-1222. Thank you.

Poison Help : Call 1-800-222-1212

General Information

The Texas Poison Center Network was established in 1993 by the 73rd Texas Legislature in Senate Bill 773 (Health and Safety Code 777), which mandated six regional poison centers to provide emergency treatment information and public and professional education regarding poisonings or toxic exposures by providing 24-hour access to health care information to reduce health care costs.

The Network provides a 24-hour, 365 days a year, emergency telephone number resource for all Texas citizens. By simply dialing 1-800-222-1222, Texans have access to a 24-hour toxicology referral service staffed by specially trained physicians, pharmacists, and nurses. In 2006, the Texas Poison Center Network handled 358,886 calls. In addition, network educators work with schools, health care facilities, industries, and families to educate communities about the dangers of accidental poisonings and how to prevent them.

The Texas Poison Center Network is a joint effort among the six regional poison centers, the Commission on State Emergency Communications and the Texas Department of State Health Services (formerly the Department of Health). Together, these agencies work to improve the quality of care provided to callers by enhancing and revising treatment protocols, sharing knowledge, and efficiency utilizing state-of-the-art telecommunications capabilities.

The poison centers are individually staffed by specially trained doctors, pharmacists, nurses, toxicologists, and educators. When exposures occur, the specially trained poison center staff provide immediate treatment advice to the caller.

In 1996, one of the Texas Poison Center Network affiliates, the North Texas Poison Center, completed a 15-month study of 1,425 calls originating from 9-1-1 centers. The evidence provides further support of the cost savings provided by poison centers. The study estimates that 50 percent of the cases handled at home would have been transported to a hospital. Without the poison center's intervention, these cases would have resulted in $306,908 of health care expenses.

Through automatic call distribution features, if a poison center has no phones available, a call to 1-800-222-1222 automatically forwards to the next available poison center until the call is answered. The next available agent could be across the state; however, the caller will see no difference in response time. This system is particularly useful should an entire poison center have to close down. In such instances, the other poison centers may manage calls for the closed poison center. For example, when Hurricane Rita caused the Southeast Texas Poison Center in Galveston to close down in September 2005, the other poison centers were able to handle calls originating from that poison center's catchment area.

As a result of a federal public health emergency preparedness grant received in 2007, each poison center now has agents who are able to work from remote sites, such as their homes. These remote agents are useful in situations such as poison center closures or sudden surges in call volume. For example, when Tropical Storm Edouard caused the Southeast Texas Poison Center in Galveston to close down in August 2008, the poison center's remote agents were still able to handle calls.

In addition to the automatic call distribution features, the telecommunications network provides the calling party's telephone number if available - a feature that can be lifesaving if a caller gets disconnected. In the case of those calls transferred from 9-1-1 centers, the Texas Poison Center Network has the ability to automatically receive calling parties telephone number, address, and name information, if it is available. Each poison center has a "smart" database that identifies, as closely as possible, the 9-1-1 center serving a particular caller. This feature can also be lifesaving in those cases when immediate medical attention is needed. The poison center has the capability to conference callers with 9-1-1 centers without disconnecting the caller.

The Texas Poison Center Network has taken every effort to meet the needs of hearing impaired and non-English speaking individuals. Each workstation in the Texas Poison Center Network has integrated telecommunications devices for the deaf (TDD). To anticipate the needs of the non-English speaking community, the Texas Poison Center Network has an agreement with AT&T Language Line for translation services. The Texas Poison Center Network also includes the first totally bilingual English-Spanish poison center, one of few in the country. The West Texas Regional Poison Center in El Paso is currently fully staffed by bilingual personnel. Many of the other poison centers are also at least partially staffed by Spanish-speakers.

All calls entering the Texas Poison Center Network are answered by trained professionals. These professionals include Specialists in Poison Information (SPI) who have a level of education ranging from pharmacists and registered nurses to those with doctorates in Pharmacology.

All of the poison centers in the Texas Poison Center Network are members of the American Association of Poison Control Centers (http://www.aapcc.org) and have been certified by this national organization of poison control centers. The Texas Poison Center Network is working toward system certification as a whole. System certification would allow the Texas Poison Center Network to operate with even greater efficiency by reallocating resources between the poison centers.

The poison centers of the Texas Poison Center Network record information from calls using the Toxicall program and Toxic Exposure Surveillance System database used by the American Association of Poison Control Centers. In the Toxic Exposure Surveillance System database, exposure, diagnostic, and demographic information is entered using a set series of data fields and codes. Thus every effort is made for data from calls to be consistent between the poison centers in Texas and to allow for comparisons and compilation with data from other states. This system allows for the efficient analysis of call data. Data are reviewed by the American Association of Poison Control Centers, poison center staff, and the Texas Department of State Health Services for completeness and accuracy.

In general, calls to poison centers are voluntary and callers may refuse to provide whatever information they wish. The information on calls to poison centers is kept strictly confidential.

For much of the existence of the Texas Poison Center Network, each poison center maintained its own database on received calls. Periodically the data were sent from the six poison centers to a central location, where the data were combined. This was an inefficient and time-consuming process. In March 2004, the Texas Poison Center Network installed a centralized database to which all poison centers add data on a real-time basis. Through this database, the poison centers have access to one another's case files, which is important because a given poison exposure may be handled by more than one poison center. The Department of State Health Services also has access to this centralized database; this allows for more timely analysis of data as well as identification and evaluation of emergency events involving multiple victims, such as terrorist attacks.

The Health Insurance Portability and Accountability Act (HIPAA) and Texas Poison Center Network

On April 14, 2003, the Health Insurance Portability and Accountability Act (HIPAA) Privacy Standards were implemented. Some health care providers have questioned whether HIPAA prohibits them from providing patient information to the Texas Poison Center Network. The Office of General Counsel of the Texas Department of State Health Services reviewed the issue and drafted a letter dated March 29, 2004, stating that health care providers can provide patient information to the Texas Poison Center Network. Click below to download a copy of this letter.

HIPAA letter from General Counsel: Download PDF File (671K)

Texas Department of State Health Services Involvement

The Epidemiology and Disease Surveillance Unit of the Texas Department of State Health Services jointly administers the Texas Poison Center Network with the Commission on State Emergency Communications (State 9-1-1). An interagency contract between the Commission on State Emergency Communications and the Texas Department of State Health Services funds the administration of the six poison center contracts, as well as the purchase of public education materials. The contract funds staff who coordinate these activities and who analyze the data generated by the six poison centers. Believing poison prevention education to be an important service, prevention of poisoning through public education for children and adults alike is coordinated and facilitated by the Texas Department of State Health Services statewide.

Poisonings are a significant cause of injury and premature death, yet, until the Texas Poison Center Network was created, very little was known about the scope and magnitude of the problem in Texas. Analyzing the information collected by the poison centers on received calls helps define poison injuries in Texas. The epidemiologist of the Texas Department of State Health Services assigned to the Texas Poison Center Network identifies trends and patterns of poisonings in Texas to help target education and prevention innovations and services to reduce the impact of poisonings in Texas.

Reporting of Controlled Substance Overdoses

Although reporting poisonings to poison centers in Texas is generally voluntary, in 1999 the 76th Texas Legislature passed Senate Bill 43 (Texas Health and Safety Code 161.042), which requires physicians to report overdoses of controlled substances in Penalty Group 1 of the Texas Controlled Substances Act to the Texas Department of State Health Services:

Sec. 161.042. MANDATORY REPORTING OF CONTROLLED SUBSTANCE OVERDOSES.
(a) A physician who attends or treats, or who is requested to attend or treat, an overdose of a controlled substance listed in Penalty Group 1 under Section 481.102, or the administrator, superintendent, or other person in charge of a hospital, sanitorium, or other institution in which an overdose of a controlled substance listed in Penalty Group 1 under Section 481.102 is attended or treated or in which the attention or treatment is requested, shall report the case at once to the department.
(b) A physician or other person who reports an overdose of a controlled substance under this section shall include in the report information regarding the date of the overdose, the type of controlled substance used, the sex and approximate age of the person attended or treated for the overdose or for whom treatment was sought, the symptoms associated with the overdose, the extent of treatment made necessary by the overdose, and the patient outcome. The physician or other person making the report may provide other demographic information concerning the person attended or treated or for whom treatment was sought but may not disclose the person's name or address or any other information concerning the person's identity.
(c) A hospital, sanitorium, or other institution that makes a report under this section is not subject to civil or criminal liability for damages arising out of the report. An individual who makes a good faith report under this section is not subject to civil or criminal liability for damages arising out of the report.

The Texas Department of State Health Services decided that this information should be reported through the Texas Poison Center Network. However, information on the identity of the person involved in the overdose is not provided to the Texas Poison Center Network. To report a controlled substance overdose meeting these criteria, either call your local poison center at 1-800-222-1222 or fax the form at the following link to your local poison center.

Fax numbers:

  • Texas Panhandle Poison Center in Amarillo: 806-354-1667
  • North Texas Poison Center in Dallas: 214-590-5008
  • West Texas Regional Poison Center in El Paso: 915-534-3809
  • Southeast Texas Poison Center in Galveston: 409-772-3917
  • South Texas Poison Center in San Antonio: 210-567-5718
  • Central Texas Poison Center in Temple: 254-724-7408

Medical License Board Poison Center Information

In 2003, the 78th Texas Legislature passed Senate Bill 144, which requires various medical licensing boards to provide license holders with information on poison center services at least once each biennium.

To assist in fulfilling this obligation, the Texas Department of State Health Services created this website, to which the various boards can provide links from their own websites.

Department of State Health Services Collaboration

The Texas Poison Center Network provides data on reported pesticide exposures to the Pesticide Exposure Surveillance in Texas (PEST) program and the Hazardous Substances Emergency Events Surveillance (HSEES) program being conducted by the Texas Department of State Health Services. The PEST program conducts investigations of pesticide poisonings when appropriate. The HSEES program conducts investigations on spills or releases of hazardous chemicals.

Pesticide Exposures

The Texas Poison Center Network provides data on reported pesticide exposures to the Pesticide Exposure Surveillance in Texas (PEST) program being conducted by the Texas Department of State Health Services. The PEST program conducts investigations of pesticide poisonings when appropriate.

Terrorism and Other Public Health Emergencies

Since September 11, 2001, the United States government and the public have placed tremendous emphasis on biological, chemical, and nuclear terrorist attacks. Poison centers receive calls regarding exposures to a variety of substances, including those that might be used in a terrorist attack. Thus the Texas Poison Center Network might assist in the early detection of potential terrorist attacks. The Texas Poison Center Network has put into place a policy to report potential terrorist attacks to the appropriate state authorities.

Poison centers also function as information sources for the public and health care providers on the risk factors for and management of a variety of exposures. Therefore, it might be expected that poison centers would serve as information repositories for the agents likely to be used in terrorist attacks. The Texas Poison Center Network has in the past received requests for information on such agents as anthrax.

In order to address the potential of terrorist attack, the U.S. Congress appropriated funding to the Centers for Disease Control to provide support to poison centers across the nation. This funding allows the centers to conduct real time disease detection, which monitors the occurrence of diseases and events that might signal a terrorist attack.

As part of the Real Time Disease Detection grant, an educational component was included in the grant objectives. The first objective was to increase the Texas Poison Center Network agents' awareness of the signs and symptoms of diseases and conditions that may signal the beginning of a potential disaster. It is also important to increase this same awareness among physicians and emergency medical professionals since they, most likely, will be the first in contact with victims of an event. This awareness can be critical to the protection of the medical professionals needed to address the care of exposed victims.

To meet these objectives, five Advanced HazMat Life Support courses were conducted. Two courses were held to train the Texas Poison Center Network agents, with three courses conducted to train EMS personnel, physicians, medical students, and other healthcare providers and administrators. Upon completion of the two day training and successfully passing the final examination, the attendees received a four-year certification. The course attendees felt the training broadened their abilities to recognize and further investigate conditions seen in their practices. EMS personnel will be more aware and better able to protect themselves and the professionals they encounter in order to prevent the spread of potential toxic exposures.

While this training was conducted as a response to public health preparedness, the awareness gained by the healthcare providers is necessary in daily life. When accidents occur involving toxic substances and/or toxic chemicals, the knowledge gained through these courses will be useful in dealing with the exposures and injuries that occur.

Additional Information

Additional information on the Texas Poison Center Network, and in particular the individual poison centers, can be found at http://www.poisoncontrol.org.

Last Updated April 18, 2016

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