Drug, Children Drugged with SSRI uRe: CARETAKERS ROUTINELY DRUG FOSTER CHILDREN

November 18, 2004

Today's medicated foster children are tomorrow's Hitler youth who will not

have a conscious when shooting disobedient unmedicated protestors. You've

seen Schlinder's list.

You know it's possible without the drugs.

Or perhaps those SS officers were being drugged by the medical researchers?

DID YOU CONTACT THE LIBERTY COMMITTEE AND CONTACT YOUR CONGRESSPERSON TO

STOP FUNDING IN THE SENAT THIS WEEK FOR MANDATORY MENTAL HEALTH SCREENING

FOR CHILDREN???????

DO IT NOW, THE GRANDCHILDREN YOU SAVE MAY BE YOUR OWN!!!

ILENADEKEE 8UR RUAi

http://www.ritalindeath.com/drugchildrentodeath.htm

CARETAKERS ROUTINELY DRUG FOSTER CHILDREN

Psychiatric medication could do irreparable harm, experts say. Often,

consent is lacking.

Children under state protection in California group and foster homes are

being drugged with potent, dangerous psychiatric medications, at times just

to keep them obedient and docile for their overburdened caretakers.

A review of hundreds of confidential court files and prescription records,

observations at group homes as well as interviews with judges, attorneys,

child welfare workers and doctors across the state, revealed that

youngsters are being drugged in combinations and dosages that experts in

psychiatric medication say are risky--and can cause irreversible harm.

In part because of a lack of oversight, officials responsible for the

children's welfare say they don't know how many of the state's 100,000

foster children are being given mood-altering medications, many of which

have never been tested for use on children.

In Los Angeles County--which has nearly half the state's foster

children--dependency court judges last year approved requests to medicate

about 4,500 kids. That doesn't include those drugged with parental consent

or those drugged with no consent at all, which experts believe is a

significant problem. In addition, a county grand jury found in 1997 that

nearly half the group home children it examined were drugged without court

or parental consent.

Experts from around the state said widespread drugging, both with and

without legal approval, occurs in other California counties as well.

" We sometimes don't know who put kids on drugs and why, " said

Nishimoto, an Orange County Department of Children and Family Services

official who, until recently, was in charge of tracking children in the

county's care.

There's the 5-year-old boy in a Tustin group home who was not only being

given an antipsychotic, but massive doses of Ritalin and clonidine--though

researchers from UCI and UCLA have published articles reporting that that

combination has caused sudden death and heart problems in some children.

There's the 8-year-old foster child in San Francisco County on Cylert for

his hyperactivity, despite warnings from the drug's manufacturer that its

use can lead to liver failure and death in children. The boy did not

receive the requisite blood checks to monitor the drug in his system.

At the Orangewood Children's Home in Orange County, kids as young as 3

skip up to the drug cart several times a day, to take the " meds " that

control their " depression " and " rage. " To say nothing of the scores of

California teenagers prescribed pills to battle manias and psychoses with

little explanation of why or by whom.

Many psychiatrists vigorously defend the use of psychotropic medications on

children in foster homes and group homes, arguing that the benefits of

using them on these often troubled youths outweigh future risks of harm.

" Your hand gets forced when these children are so disruptive, " said

professor M. Stahl, who teaches psychopharmacology at UC San

Diego. " How sick would they be if you didn't give them drugs? " he asked.

Dr. Hogrebe, who works with grade-school-age children at an Anaheim

group home, said, " Most [of these medications] can be used safely, if

they're monitored correctly. "

But the lack of proper monitoring is precisely part of the problem, say

numerous officials involved in the child welfare system.

Prescription Records Scant or Nonexistent

Many child psychiatrists, attorneys and children's advocates say the

apparently widespread practice of drugging amounts to a form of medical

experimentation on some of the state's most vulnerable kids--those taken

from parents who abused them.

In many instances, the doctors who prescribe what their colleagues call

" chemical straitjackets " aren't psychiatrists and have little training in

the highly specialized field of psychiatric medications.

According to group home directors and child care workers, some of these

doctors and psychiatrists examine a child for minutes before prescribing

powerful, behavior-altering medications. And some come after dark, when

children are asleep, look at files and write prescriptions.

These revelations come at a time when many experts have expressed serious

reservations about the rising number of kids in the general population who

are being prescribed adult medications.

An estimated 800,000 children and adolescents nationwide last year were

prescribed antidepressants such as Prozac, Paxil and Zoloft, according to

IMS America, an industry research firm that surveys physicians. Another

half a million children, aged 6 to 12, were prescribed Tegretol and

Depakote, two adult antimanic, antiseizure drugs, the firm's data shows.

And in 1996 some 3.25 million in that age group were prescribed drugs such

as Ritalin to control hyperactivity, IMS America says. Controversy or no,

such drug use by kids in the general population is at least monitored by

parents and physicians.

But psychiatrists in several California counties say sometimes the only

way they know what drugs a child in a foster home or group home has been

taking is if the child can remember such obscure names as Desyrel (an

antidepressant), Mellaril (antipsychotic), Tegretol (antimanic) or Catapres

(antihyperactivity).

One Orange County teenager filled a notebook page with the cornucopia of

drugs she'd been given; few of the drugs had been logged in her official

files.

An 8-year-old state law requires that foster children's medical histories

be recorded in " medical passports " and follow them from home to home. But

this requirement is routinely ignored as too burdensome, officials say, and

children's medical records are often incomplete. For most kids, every time

they move, their care passes to different physicians and psychiatrists.

" When I get a new kid, I have no idea what [medications] he's been on, "

said Dr. Steinhoff, UC Irvine's chief of child psychiatry, who also

sees children in a group home. " I don't know who the [child's previous]

doctors are. You get practically nothing. It's a crime. "

In San Bernardino County, Jeff Broyde, head of the public defender unit

representing children, said it's difficult for his office to monitor

whether a child is getting proper treatment; each attorney in his office

represents some 1,200 children who sometimes are housed hundreds of miles

away.

" There's no way we can run out there and see . . . if the child is OK, " he

said. " The important thing [is] seeing the child. If you see a child

looking like a zombie, it's wrong, even if it's medically permitted. "

In numerous interviews across the state, one official after another--from

individual foster parents to judges to doctors--described occasions where

children seemed to be misdiagnosed, given the wrong medication or given too

much medication.

* In Los Angeles County, judges who oversee the cases of foster children

have become so concerned by the widespread disbursement of drugs that in

April they imposed a system designed to ensure that a child had been

thoroughly examined and that other options had been tried before

psychiatric drugs were prescribed. Each psychiatric diagnosis and

prescription must be reviewed by county psychiatrists before court

approval.

" We all have enormous fears that our decisions, one way or another, are

going to cause serious harm to these children, " said Terry Friedman,

presiding judge of the L.A. County dependency courts. " This, more than any

other decision as a judge, causes me enormous anxiety. "

Drugging Without Consent Widespread

One of the new policy's architects doubts it will provide a complete

answer to the problem. A report by the Los Angeles County Grand Jury in

1997 suggested that his concerns are valid: An audit of 158 cases found

that children in group homes were being drugged without the legally

required consent nearly half the time.

Dr. Malkin, chief of mental health services for the county's

juvenile courts, said there is no real punishment for doctors who don't

seek court approval, and reviewing the consent forms that are submitted

doesn't answer the basic questions: Does the child truly need the

medication, and do a drug's benefits outweigh its sometimes serious side

effects?

Tobin, the county's mental health coordinator, said the sheer number

of doctors treating children in Los Angeles makes quality control nearly

impossible. Last year, more than 400 doctors requested court permission to

drug nearly 4,500 children--more than 300 under the age of 6. And these

numbers don't include the many children whose parents consented to the

medication, precluding the need for court approval. Nor do they account

for the number of foster and group home kids, such as those the grand jury

found, who had been drugged without anyone's consent.

* In San Diego County, Juvenile Court Referee Imhoff says

legislative intervention might be the only way to control the use and

misuse of psychiatric medications. " I think everyone will agree that the

scope of this problem is expanding, " Imhoff said. " It's a systemic

problem. "

Imhoff said the court's supervising judge now reviews every request to

medicate a child, and San Diego's dependency court judges are " absolutely

frightened " that children are being drugged without their knowledge.

Sooner or later, he said some calamity will occur " that will be very

difficult to explain. "

Some Homes Seem to Sedate All Toddlers

Ana Espana, who supervises the unit in the county public defender's office

that represents foster children, said she has personally encountered cases

of foster children being drugged improperly.

" We had a 5-year-old client who was kept in a psychiatric hospital for

over a month, who had multiple changes of medication, and we didn't find

out for weeks after, " said Espana. " Our feeling was this child was being

experimented on. We got him out and into another facility, and they [the

doctors at the second hospital] were horrified by what he'd been on. "

She said she had been to foster homes where all the toddlers appeared to

be sedated, and her office would later find out the children were drugged

without anyone's permission.

* In the Bay Area, several psychiatrists who treat foster children say

they regularly see children who have been put on multiple medications by a

variety of doctors. Dr. Lynn Ponton, a professor of adolescent psychiatry

at UC San Francisco, said a 14-year-old girl who had been living in a

group home recently showed up for an appointment on antipsychotics and

antidepressants. " She'd been on these medications for a year and nobody

knew why she was on them or who put her on them, " Ponton said. " They dump

[kids] on these meds instead of worrying about continuity of care and

therapy. "

* In Orange County, controversy over the questionable use of psychiatric

drugs on foster children has surfaced before. More than three years ago,

the county hired a UCLA professor, a Torrance psychiatrist and a

pharmacologist from a state hospital to investigate complaints by one of

its own managers that children at the county's temporary shelter,

Orangewood Children's Home, were being improperly medicated.

The report has never been made public, but the county's Juvenile Justice

Commission last summer released a brief summary of the major findings,

accusing some Orangewood psychiatrists of jeopardizing the health and

well-being of children in their care by deviating from " normal, customary

practices " in prescribing psychiatric drugs.

Daun , a psychologist and former chairwoman of the Juvenile Justice

Commission, said she was " shocked " at the practices at the shelter. " It

was apparent from the consultants and the records that there were some

serious health risks to children, " said.

Tim Mullins, until recently the county's director of mental health

services, said the problems at Orangewood have been corrected.

But according to several child psychiatrists, who reviewed approved

medication consent forms for children staying at Orangewood, problems

persist. The medications requested on some consent forms didn't correspond

to the diagnoses, the psychiatrists said, and the amount and combinations

of drugs in some cases were " outrageous. "

In one case, a county psychiatrist put an 11-year-old girl on large

amounts of Tegretol, Depakote and Clonidine for attention deficit and

hyperactivity disorder and " aggression/agitation. " Dr. Hicklin,

head of the child psychiatry ward at the Los Angeles County-USC Medical

Center, said either the diagnosis or the medication had to be wrong.

" That's appropriate treatment for mania and bipolar disorder. You wouldn't

treat ADHD with those drugs, " Hicklin said.

In another case, an Orangewood psychiatrist asked to put a 15-year-old boy

on massive doses of the antipsychotic Risperdol " indefinitely, " and the

antidepressant, Trazodone, for behavior outbursts, impulse control and

insomnia. " There would be no justification in the literature for such

treatment, " said Dr. McGough, an assistant professor of child

psychiatry at UCLA, who reviewed the boy's medications. The psychiatrist

" is putting this child on medication for a grown man with full-blown

schizophrenia. In my mind, it borders on criminal. "

Dr. Pascarzi, the county child psychiatrist who reviews all the

medications prescribed at Orangewood, says " those two cases would

certainly be considered unusual, " though he is comfortable with the

medication in both situations. He said he would need to know more about

the 11-year-old girl's medical background to judge whether the combination

and doses of the drugs were correct, whether other medications had been

tried first and what levels of the drugs were detected in her blood tests.

Pascarzi says that at least while the children are at Orangewood, they are

given complete medical evaluations and, if necessary, monitored with EKGs

and blood tests to make sure the medications are not harming them.

There's no question that the use of adult-strength medications to relieve

depression, and to control manias, psychoses and rage, were at one time

well-intended and a valid means to help the system's most severely

disturbed children. But as the number of kids in the child welfare system

has exploded over the last decade, so too has the use of powerful,

controlling medications on children, some of whom may not need them,

experts say.

Joe Huley, in charge of group home inspections for the Orange County

Department of Children and Family Services, ordered one Tustin group home

for children ages 3 to 12 to fire its psychiatrist in 1996, after

discovering that the doctor was prescribing the tranquilizer Thorazine for

every child in the home--whether they needed the medication or not.

Prescribed for Need or for Convenience?

Many parents say they believed their kids didn't require medication but

felt pressured to sign consent forms because they hoped to regain custody

of their children and didn't want to appear uncooperative.

" What can I say about it? If I protest, they'll say I don't care about the

kids, " said Janet Van Eyk of Orange, whose three grandchildren were taken

from her after she was accused of abusing one of them. " I had the girls

assessed at school for hyperactivity and they said they didn't need drugs.

Now they have them on them. "

While many kids do need treatment, many others in the state's care are

drugged for expressing normal angry reactions to abuse and abandonment--or

for just being rambunctious kids, say children's attorneys and some

psychiatrists.

Psychiatrists, or sometimes simply internists, employed by some group

homes respond to the complaints of harried child-care workers by

prescribing medications or increasing dosages on the basis of a phone call

from an untrained worker, say child advocates and the workers themselves.

" Putting kids on medication is easier for the people who care for them, "

said Dr. Euthymia Hibbs, chief of psychosocial treatment research for

children and adolescents at the National Institutes of Health. " It is more

convenient for everyone around--but the kids. "

J. , an Orange attorney who represents children in

protective custody, agreed, " The group home calls up and says, 'ny is

acting up.' So they give him a drug. It's perennially a problem in these

group homes. "

Dr. Chadwick, director emeritus for the Center for Child Protection

at the Children's Hospital of San Diego, said doctors and court officials

there became concerned when it appeared that foster parents were having

unruly children put on medication without proper examinations or consent.

In two separate instances, Chadwick said, foster children ages 4 and 5 came

in for medical exams taking antipsychotics and antihyperactivity drugs.

" The foster mothers had relations with certain doctors where they could

just call up and get meds, " Chadwick said. " There was not what I considered

a sufficient evaluation before they prescribed the drugs. "

Professor Stahl from UC San Diego places part of the blame on a child

welfare system that cheats doctors of the resources they need to do their

jobs. " The doctors don't have time to make an assessment. The fastest

thing is to use chemical straitjackets on the kids--and some of them

probably need it.

" You're forced to use drugs because [the group homes] are understaffed and

they're unnatural environments, " Stahl added. " The facilities have to be

safe. "

Usually there are three or more traumatized kids for every group home

staffer, though there can be as many as eight. The workers, typically

fresh out of college, are paid $7 to $9 an hour and seldom stay longer

than a few months. Drugging kids is cost-effective: Most pills cost from 3

to 17 cents. Therapy is an expensive proposition.

" A lot of these kids suffer from a deficit in attention, not attention

deficit disorder, " said Swanson, a psychologist who heads UCI's Child

Development Center.

" If we were to get more one-on-one with these kids over a longer period of

time, " said Chavez, a senior counselor at Orange County's

children's shelter, " they wouldn't need all those meds. "

It is resoundingly unclear how " all those meds " may be altering children's

lives. Anecdotally, however, experts say there are numerous disturbing

accounts.

Under the influence of such drugs, children have suffered from drug-induced

psychoses, hallucinations, abnormal heart activity, uncontrollable tremors,

liver problems and loss of bowel control, according to health

professionals, attorneys and court records.

The manufacturers of some drugs, such as the antidepressant desipramine,

specifically warned doctors not to give the drug to kids after some

children became ill or died as a consequence of taking the drug. " We

advise against using [desipramine] in children, " said Rouse, U.S.

director of communications for Hoechst n Rousell, the maker of the

antidepressant.

Because the drugs have been approved by the U.S. Food and Drug

Administration for adults, a doctor can prescribe them to patients of any

age, even though they have not been tested on children.

" These drugs can result in a toxic reaction, either something that makes

the child really sick or . . . makes the kid dead, " said Dr. Chadwick from

the Center for Child Protection in San Diego. Chadwick was hired as a

consultant in a court case involving a Seattle foster child who died in

1996 after being given toxic doses of an antihyperactivity drug.

No foster children in California are known to have died from excessive or

improper medications. But child advocates say prescription drugs could have

played a role in some cases where death was blamed on unexplained heart

arrhythmia or other organ failures.

One such death occurred in March in San Bernardino, where a 10-year-old boy

in a group home was found to have died of a heart attack brought on by

unknown factors. A police detective said toxicological tests showed that

the medications in his system were within acceptable limits, so the death

may never be explained.

Beyond the physical side effects, experts worry about how or if these

medications affect children's ability to have normal relationships, to

learn, and to have and rear children of their own.

Children between the ages of 3 and 6 who take antipsychotics such as

Mellaril and Haldol have been found to have learning problems. " Your brain

is wired to learn things during that period that you can't learn later, "

Dr. McGough from UCLA said. " There's a real risk. Nobody knows the

long-term effect. "

Some doctors and child advocates worry that the pills set the children,

often the progeny of drug abusers, on a lifetime of drug dependency.

" This is the wrong message to send to children: 'Take this pill and you'll

feel better,' " said Dr. Laughren, medical reviewer for the FDA's

division of neuro-pharmacological drugs.

Added McGough: " You're really teaching them that they're dependents and

damaged and need drugs to be normal. "

Some psychiatrists may be unaware of the serious side effects that some of

these drugs can have, because they spend so little time with the

children--unlike their caretakers.

At a Tustin group home, one 3-year-old boy appeared so dazed and

incommunicative that a therapist said he would never leave the child

welfare system or his medications, that he was retarded and unadoptable.

But when Greta , a Costa Mesa foster parent, took in the 30-pound

boy she learned he was being given large doses of clonidine, a drug used to

fight both depression and hyperactivity, three times a day.

" The amount of medication he was on for a 3-year-old was just incredible, "

said. " Once we got him off the drugs, his vocabulary increased

tenfold, he was potty-trained and his medical diagnosis went from mental

retardation to learning disabled. "

" I'm not against medications, " said , who is in the process of

adopting the boy. " I'm against sedating children. "

Dr. Malkin also sees the effects of over-drugging. He recounted the case

of a 9-year-old girl in Los Angeles County who ended up back at the county

children's shelter after attacking her foster sister with a knife. The

girl's Ritalin prescription had been upped to dosages far beyond those

recommended for her age and weight, Malkin said.

" She was psychotic when she got [to the shelter,] " Malkin said. " She just

had a toxic amount of Ritalin in her system. When we took her off the

medication, she was fine.

" The only real solution, " Malkin said, " is to have social workers with

caseloads of 10 kids. The thing that's missing is to have someone in the

parental role. Someone who shares the child's destiny. "

* DAILY PILL ROUTINE: and Kenny's ritual is repeated across

California.

November 18, 2004