Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 I wish someone in NY would make a FOIA request to find out how many of these children were diagnosed on the spectrum and what drugs they're being given (these types of requests are sometimes illegally refused, since the specifics give activists more ammunition) and who's prescribing them. I think it would be very telling and could provide a supportive argument for discussion of alternative medical treatments. ALLIANCE FOR HUMAN RESEARCH PROTECTION Promoting Openness, Full Disclosure, and Accountability http://www.ahrp.org <http://www.ahrp.org/> and http://ahrp.blogspot.com FYI We are cautiously optimistic that our relentless call for investigations of the misuse of hazardous psychotropic drugs in children (as well, the elderly) is being picked up by the press /media. A two day investigative series of reports by the Democrat and Chronicle (Rochester, NY) uncovered evidence of abusive drug prescribing for children in New York 's foster care. In Monroe County, 1 of every 8 children in foster care is on antipsychotics, drugs so toxic they are shortening lives of adults by 25 years. [1] Children are at even higher risk of profound harm caused by these drugs. [2] The Democrat & Chronicle sought to determine whether Monroe County foster children are being over-medicated. D & C interviewed dozens of families and experts, and analyzed state and county data. Documents obtained by the D & C under the Freedom of Information law reveal that: * In 2002, about a third of the county's foster care population, 327 children, were prescribed one or more common psychotropic drugs. * By the end of 2006, the number had increased about 40% (457 foster children) or almost half of the county foster care population. * In the five years from 2002 through 2006, according to state data, Medicaid expenditures for common psychotropic medications for Monroe County foster children nearly doubled - an increase almost four times the statewide rate. * Psychotropic medications are also more commonly used at residential foster care treatment centers than in the past, according to medical and psychiatric staff. * At the nonprofit Hillside Children's Center, for instance, 55% of the foster children are prescribed one or more psychotropic drugs. * 2006 records show that more than 1 of every 8 foster children in Monroe County is on some kind of drug to combat psychosis, a severe form of mental illness characterized by lost contact with reality. * Very young children are also prescribed the psychotropic medications, according to county data. Last year, a 1-year-old foster child was prescribed the antipsychotic drug Risperdal, and two 4-year-old foster children were prescribed Depakote. Pediatricians say Risperdal and Depakote, if properly monitored, can be safely prescribed for young children, but some medical experts worry about possible health effects. Risperdal has been associated with heart disease in older adults; Depakote has been linked to liver failure in children younger than 2. Children in the foster care system have no caring parents to protect them. Thus, they are at highest risk of abuse: they are being drugged instead of loved by state-licensed, taxpayer subsidized " care " givers who are profiting from abusive use of these drugs-that's how these drugs became blockbuster profitable cash cows. [3] There is no credible evidence that children are benefiting from antipsychotics--such as Zyprexa, Risperdal, or Seroquel. There is no evidence that children benefiting from anticonvulsants such as Depakote. These Toxic drugs carry Black Box label warnings about debilitating and potentially lethal effects-yet, they are being irresponsibly prescribed as chemical restraints for helpless children and infants of all ages. The D & C discussed the prescribing problems with one of the more responsible child psychiatrists in the state of NY, Dr. Irwin, a Syracuse-area psychiatrist who has been contracted by counties and treatment centers around the state to help decrease the use of psychotropic drugs for foster children. Dr. Irwin stated flatly: " I have no doubt that many, many kids are overmedicated. " He expressed concern that " colleagues are too quick to pin a " disorder " label on a child and turn to drugs when intensive counseling and therapy would be a safer, more effective approach. " The D & C reports that many have challenged the recent surge in the diagnoses of adolescent bipolar disorders, for which Depakote is often prescribed. The evidence of prescribing abuses points to a major crisis in the US: mental health professionals under the influence of Big Pharma are abusing their license by wantonly prescribing toxic drugs that will destroy children's mental and physical development. [stay tuned for forthcoming Infomails about the industry-influenced unique US bipolar " epidemic " among children.] References: 1. Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Preventing Chronic Disease, 2006 Apr. Available from: [Link] 2. CORRELL CU. CARLSON HE. Endocrine and Metabolic Adverse Effects of Psychotropic Medications in Children and Adolescents J. Am. Acad. Child Adolescent. Psychiatry, 2006;45(7):771 Y 791. 3. GARDINER HARRIS, BENEDICT CAREY and JANET ROBERTS, Psychiatrists, Children and Drug Industry's Role, New York Times, May 10, 2007 http://ahrp.blogspot.com/2007/05/psychiatrists-retained-by-drug- industry.htm l Contact: Vera Hassner Sharav veracare@... 212-595-8974 Day 1 story (Dec. 9, 2007): Potent Pills: More foster kids getting mood-altering drugs Documents Family Court ruling http://www.democratandchronicle.com/assets/pdf/A293429126.PDF Riley affidavit http://www.democratandchronicle.com/assets/pdf/A293528127.PDF Database Adverse affects of psychotropic drugs Drug warning Psychotropic medications can cause injurious side effects if a child cannot tolerate the type of drug or the dosage. Some stimulants, such as Ritalin, can cause quickened or uneven heartbeats and increased blood pressure. Antipsychotic drugs, such as Risperdal, have been linked to weight gain and diabetes. Antidepressants have been linked to an increased risk of self-injury or suicidal thoughts. ~~~~~~~~~~~~~~~ http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071209/NEWS 01/71206023/1002/NEWS DEMOCRAT AND CHRONICLE December 9, 2007 Potent Pills: More foster kids getting mood-altering drugs Craig <mailto:gcraig@...> When Laticia 's son entered foster care in 2005, a social worker described the 4-year-old as " an extremely smart little boy who loves school. " But over the next six months, as he was shuttled from an emergency foster-care placement to two foster homes, his personality changed. The boy would explode in tantrums, gouge his own flesh, even consider killing himself. Social workers and pediatricians could not quell his outbursts. Frustrated, they resorted to Depakote, an anti-seizure medication intended for adults but occasionally given to children to alter their moods. And then her son's personality really changed, said. The boy she knew as playful and exuberant was, when she visited him, distant and withdrawn - " almost like a zombie. " Like 's child, hundreds of foster children in Monroe County each year are placed on psychotropic, or mood-altering, drugs. Though questioned in some medical and psychiatric quarters because of long-term health risks, the use of the psychotropic medications on foster care children in Monroe County is on the rise, a Democrat and Chronicle investigation shows. The investigation included analyzing data from county, state and federal agencies; interviewing experts locally and nationwide; interviewing families of some local foster children on medications; and reviewing public records of Monroe County Family Court cases in which the prescription of the drugs has been an issue. The investigation reveals that: * In 2002, about a third of the county's foster care population, 327 children, were prescribed one or more common psychotropic drugs. By the end of 2006, the number had increased about 40 percent to 457 foster children, <javascript:NewWindow (405,400,'http://www.democratandchronicle.com/graphics/ Kids.jpg');> or almost half of the county foster care population. * In the five years from 2002 through 2006, according to state data, Medicaid expenditures for common psychotropic medications for Monroe County foster children nearly doubled - an increase almost four times the statewide rate. * Psychotropic medications are also more commonly used at residential foster care treatment centers than in the past, according to medical and psychiatric staff. At the nonprofit Hillside Children's Center, for instance, 55 percent of the foster children are prescribed one or more psychotropic drugs. * 2006 records show that more than one of every eight foster children in Monroe County is on some kind of drug to combat psychosis, a severe form of mental illness characterized by lost contact with reality. * Very young children are also prescribed the psychotropic medications, according to county data. Last year, a 1-year-old foster child was prescribed the antipsychotic drug Risperdal, and two 4-year-old foster children were prescribed Depakote. Pediatricians say Risperdal and Depakote, if properly monitored, can be safely prescribed for young children, but some medical experts worry about possible health effects. Risperdal has been associated with heart disease in older adults; Depakote has been linked to liver failure in children younger than 2. Drugs a straitjacket? care advocates say children are a particularly vulnerable population, often invisible to the public and beset with higher rates of mental and emotional illness in large part because of the disruptive - and sometimes abusive - lives they've led. This leads to a conundrum: Are foster children legitimately prescribed psychotropic drugs more commonly because they have so many needs? Or are the drugs used more as a convenient way to straitjacket troublesome behavior? The use of such drugs " definitely has gone up, and I say that with much reluctance because I don't think these medications are necessarily safe medications, " said Dr. Mohsen Emami, a staff psychiatrist at St. ph's Villa in Greece, a nonprofit residential facility for troubled youths. Across the country, while the use of psychotropic medications for all children has increased, the rate of use for those in foster care has grown even faster. By some estimates, foster children receive psychotropic drugs at a rate two to three times that of other children. " I have no doubt that many, many kids are overmedicated, " said Dr. Irwin, a Syracuse-area psychiatrist who has been contracted by counties and treatment centers around the state to help decrease the use of psychotropic drugs for foster children. " It's out of control in general, but the worst problems are in foster care because there's basically nobody advocating for the kid. " Keeping tabs on drugs Local psychiatrists and pediatricians who work with foster children say that although they worry about increased use of the medications, they can ward off bad health effects by keeping close tabs on reactions to the drugs. Many of the drugs require frequent monitoring of blood levels, lipid counts or liver function, depending on the particular side effects. " We're always being as careful as we can because we want to know we're doing it safely, " said Dr. Stuart Loeb, a child psychiatrist who is medical director at Hillside Children's Center. Monroe County operates a nationally recognized clinic, called Starlight Pediatrics, for foster care children in home settings. The clinic centralizes care for foster children to ensure they receive preventive and other necessary medical treatment. Still, the clinic and Monroe County Department of Human Services, which manages foster care, have not been without controversy on the issue of psychotropic medications. Last year, Monroe County Family Court Judge Marilyn O'Connor rebuked the clinic and county social service workers in two separate cases for what she declared to be the questionable prescription of drugs to foster children. Both cases involved the prescription of Depakote - in one case to Laticia 's 4-year-old son and in the other to a 2-year-old girl. While both cases centered on whether the county received proper consent from a biological parent to prescribe drugs - parental consent is typically required for such a prescription - O'Connor in one ruling challenged whether the medication was even warranted and if the risk of side effects was sufficiently considered. O'Connor ruled that " the decision to medicate this child was based on hearsay, limited information and without any complete evaluation of an existing mental health issue by a psychiatrist or psychologist, " a contention the county has denied. O'Connor, who will retire from the bench at the end of this year, said she grew concerned because of the number of foster children she sees in court on psychotropic medications. While refusing to discuss specific cases, she said in an e-mail: " Anecdotally, many of the children who appear before me ... are on some form of medication and I believe it is higher than what is being prescribed to the general population of children. Other factors affect this, but I am alarmed by what I see in the reports I receive. " Laticia was also alarmed when she visited her son after he was put on Depakote. " He was real tired. He didn't act like a kid any more. He didn't have that play in him. He didn't have that 'go' in him. " no longer wanted him on the medication. She challenged whether she had given true consent. County attorneys argued at a hearing that the drugs were prescribed " in his best interest, " but O'Connor ordered the medication halted unless consented. Now 6 years old, the boy is in a compatible, loving foster home, said , who has three other children in foster care. And he is no longer on Depakote. " Now he's a normal kid. He laughs. He plays. He can tell you what he thinks. He couldn't do that on the meds. " Children 'more disturbed' There are about 800 children now in foster care in Monroe County, counting those in individual homes and in residential treatment centers such as Hillside and St. ph's Villa. Many have been removed from the homes of drug-addicted parents. Many have been severely abused. Many don't know the benefits of a healthy diet or even the pleasure of a good meal. The transition to foster care can add to their trauma. " They're in a neglectful, intellectually and emotionally impoverished or abusive environment " at their parental home, said Dr. Naylor, a Chicago child psychiatrist who is an expert on the use of psychotropic drugs for foster care children. " Then it just gets worse. These kids are taken out of their home and there's a disruption of parental attachment. These kids are attached to their parents, even though they are not often particularly very good parents. " About 45 percent of the school-age children seen at Starlight Pediatrics are in special education programs, half of them for behavioral or emotional problems, said the clinic's pediatric director, Dr. Moira Szilagyi. Three of every 10 children using the clinic suffer from some form of chronic illness, ranging from asthma to seizures. Szilagyi, a Mendon resident who is nationally recognized for her work with foster care children, said the clinic does not resort to psychotropic drugs without being convinced that other options, such as therapy and counseling, won't work alone. Typically, the clinic won't prescribe psychotropic medications without consulting with mental health professionals, she said. The clinic often works closely with the University of Rochester's Mount Hope Family Center to determine the best answer for a child's needs, she said. " We work very hard at getting them into services. " Still, medication may be necessary and beneficial when paired with therapy, she said. Although state and local data show that Monroe County's use of psychotropic drugs for foster children has increased, the reason behind that increase is less clear. Szilagyi said that foster children in Monroe County have greater access to services, and that higher uses of medication may be evidence that the children are being diagnosed better than in other communities. In Onondaga County, for instance, the use of common psychotropic drugs in the foster care population is even greater than in Monroe County, according to state data. Onondaga is known as a county that tries to rigorously evaluate the needs of foster children, Szilagyi and other experts said. The use of psychotropic drugs at foster care residential programs has likely increased because the county is trying to route only the most demanding children there, said , director of the Child and Family Services Division of the county's Department of Human Services. Officials at those programs agree that the needs of their children are even more dire than in the past. " I think in all of our services, we see children who are more disturbed and more dysfunctional, " Loeb said. About a third of the children at St. ph's Villa are on psychotropic drugs, Emami said, and many of them had been prescribed drugs before entering the program. " I would say at least a third of them arrive on two or three psychotropic medications. Some of them are so fragile that if you try to lower the dose, they really struggle. " Similarly, many children already have prescriptions for psychotropic drugs before they arrive at the foster care clinic, Szilagyi said. Deciding if and when to prescribe psychotropic drugs often tears at him, Emami said. " These medications have benefits - I certainly have seen it in 30 years of practice. But they also have serious side effects. " Over-prescribing? The growing use of psychotropic drugs is not a trend unique to the foster care community. The prescription for all children has significantly increased in the past 15 years. Between 1994 and 2001, the prescription of psychotropic drugs for teenagers increased by 3 1/2 times, with much of that gain coming after 1999, according to a Brandeis University study <http://my.brandeis.edu/news/item?news_item_id=104310> . Other studies show that pattern has continued. " The Holy Grail here is we want to know what's appropriate (for prescription) and what's not, " said Parks , a Brandeis University professor and expert on prescription drug trends who worked on the study. " When you have a high growth in prescribing, it can mean things are being overprescribed. On the other hand, it can mean we are identifying things that need to be treated, " said. The prescription of Ritalin and other attention deficit disorder medication has exploded in the past three decades, and in the 1980s, the prescription of antidepressants for children became more common. Antipsychotic drugs are now also given to children and teens. Irwin and other child psychiatrists worry that their colleagues are too quick to pin a " disorder " label on a child and turn to drugs when intensive counseling and therapy would be a safer, more effective approach. Many have challenged the recent surge in the diagnoses of adolescent bipolar disorders, for which Depakote is often prescribed. A recent study <http://www.nih.gov/news/pr/sep2007/nimh-03.htm> funded in part by the National Institutes of Health determined that the number of doctor visits resulting in a diagnosis of bipolar disorder of a child or adolescent increased by 40 times over the past decade. The increased use of psychotropic drugs among foster children has greatly outstripped the rate within the overall population, many studies show. This isn't surprising to those who work with foster children, given their needs. " When you look at these youngsters, one can hardly imagine a group of children or adolescents that have more stacked against them, " Naylor said. " Mental health issues. Abuse. Neglect. " But some psychiatrists say that many in the field too routinely use drugs as a remedy. Irwin said: " Most medication for foster kids is given because they have behavior that adults don't like. " GCRAIG@... Common psychotropic medications: Ritalin, Concerta (Generic: methylphenidate): Nervous system stimulants, used often in response to attention deficit disorder and hyperactivity. Abilify (aripiprazole): Antipsychotic medication often used for bipolar disorder or other mood disorders. Risperdal (risperidone): Antipsychotic medication also used for mood disorders and also sometimes for treatment of autism. Seroquel (quetiapine): Antipsychotic medication also used for mood disorders. Zyprexa (olanzapine): Antipsychotic medication also used for mood disorders. Zoloft (sertraline): Antidepressant medication. Topamax (topiramate): Antiseizure medication sometimes used to help stabilize weight. Depakote (divalproex sodium): Antiseizure medication now sometimes used for mood disorders. Lexapro: (escitalopram): Antidepressant medication. ~~~~~~~~~~~ http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071210/NEWS 01/712100344 Prescription issue hasn't had much scrutiny in N.Y. Craig (December 10, 2007) - Last month, lawmakers in Oregon said they feared there were too few safeguards to ensure foster children were safely prescribed mood-altering drugs. Earlier this year, a congressional subcommittee chairman declared that " one particularly troubling health care coordination issue is the monitoring of foster children's medication. " And a year ago, the Texas comptroller decried the increasing use of psychotropic medications for foster children, noting that " the (U.S.) Food and Drug Administration has not approved most of these drugs for use in children, the effectiveness of these drugs is in question, and the long-term consequences on learning, growth and development have not been determined. " Nationwide, medical experts and lawmakers are expressing concern that the escalating use of psychotropic medications could be placing foster children at risk. From state to state - and even county to county within states - a patchwork of rules and regulations dictates when and how the drugs can be prescribed to children who are in the foster care system. A Democrat and Chronicle investigation into the issue shows there can be distinct local variations. State data obtained under the Freedom of Information Law show, for instance, that per capita Medicaid expenditures for many psychotropic drugs for foster children in Monroe County were significantly higher than in Erie County but lower than in Onondaga County. Social services officials in 15 states said one of their most pressing issues was " overprescribing psychotropic drugs to foster children, " according to an October report from the U.S. Government Accountability Office. Officials there said New York was not one of the states. One Congressman, Jim McDermott of Washington, said in an interview last week that he intends to hold a hearing to determine whether a federal agency should ensure medications are properly and safely prescribed to foster children. McDermott, a former child psychiatrist, said the issue is not one that lends itself to easy or " cookie-cutter " answers. " Basically, what we need to do is gather more information, " said McDermott. " It's easy to make snap judgments on something like this. I think that would be something that's not good for kids. " New York has not had an official review of how the prescription of psychotropic medications to foster children compares with other states. But a statewide review could be forthcoming. The state Office of Children & Family Services this month will take steps to ensure that social service officials are receiving proper consent before prescribing psychotropic medications to foster children. OCFS officials plan to issue a directive to counties highlighting the proper consent process, said agency spokeswoman Brown. " It's a proactive measure to put some controls on this, " she said. The agency also plans to dissect data to see whether there is a significant difference between counties in how medications are prescribed to foster children, Brown said. Burton, an associate professor of law at the City University of New York School of Law, said she will seek support for an analysis of the issue in New York, and hopes to get help from researchers and nonprofit children's rights organizations. Burton, the former director of the Children's Rights and Family Law Clinic at Syracuse University College of Law, pointed out that other large states - including Texas and Florida - found high rates of psychotropic drug use for foster children. In response, those states have either enacted or are considering reforms. " Our children are probably experiencing some of the same issues, and it would serve us well and serve our children well to find out what's going on, " she said. " I think clearly children are already ... the disenfranchised and voiceless members of society, " Burton said. " And children in foster care and children in juvenile detention facilities are even further removed from the public eye. " Vera Sharav, the founder and president of the Alliance for Human Research Protection, said she expects the same troubling trends would be found in New York as were found in other states. " You have to have the political will to look under the rock, " she said. ~~~~~~ GCRAIG@... Stories Doctor critical of overuse of drugs http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071209/NEWS 01/71207037 Parental consent http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071209/NEWS 01/71207039 Issue hasn't received much scrutiny http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071210/NEWS 01/712100344 Drugs'effect on brains of kids debated http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071210/NEWS 01/712100343 Videos Caring for Jessie Dr. Irwin Dr. Moira Szilagyi Burton Related articles: .. Prescription issue hasn't had much scrutiny in N.Y. http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071210/NEWS 01/712100344/1002/NEWS .. Debate surrounds how drugs affect kids' brains http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071210/NEWS 01/712100336/1002/NEWS .. Potent Pills: Doctor critical of overuse of over-prescribing http://www.democratandchronicle.com/apps/pbcs.dll/article? AID=/20071209/NEWS 01/71207037/1002/NEWS Drug warning Psychotropic medications can cause injurious side effects if a child cannot tolerate the type of drug or the dosage. Some stimulants, such as Ritalin, can cause quickened or uneven heartbeats and increased blood pressure. Antipsychotic drugs, such as Risperdal, have been linked to weight gain and diabetes. Antidepressants have been linked to an increased risk of self-injury or suicidal thoughts. Physicians or psychiatrists should fully inform a child's parents or legal caretaker about the possible side effects and whether those side effects are cause for concern. For information about the benefits and dangers of more than 24,000 prescription drugs, including psychotropic medications, go to www.drugs.com. What's at stake The health of our most vulnerable children. Those in foster care are increasingly being treated with psychotropic drugs that can help but also harm rapidly developing brains and bodies. Some experts fear that the drugs are being overprescribed. Got tips? If you have information about local institutions that seem to over- prescribe psychotropic drugs to control the behavior of children, email: watchdog@... FAIR USE NOTICE: This may contain copyrighted (C ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit. Quote Link to comment Share on other sites More sharing options...
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