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children in NY county drugged at rising rates

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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.

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