Out Of Sight, Out of Mind: Psychotropics & Foster Care
14 CommentsBy Ed Silverman // December 10th, 2007 // 11:53 am
The use of the psychotropic meds on foster care children in one upstate New York county has grown precipitously in recent years, and the trend reflects a conundrum that frames the debate - 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?
So The Rochester Democrat & Chronicle analyzed data from Monroe county, New York state and federal agencies; interviewed experts locally and nationwide; interviewed families of some local foster children on meds; and reviewed public records of Monroe County Family Court cases in which the prescription of the drugs has been an issue. The investigation found:
- 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, 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 meds are also more commonly used at residential foster care treatment centers than in the past, according to medical and psychiatric staff. At one nonprofit, 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.
Across the country, while the use of psychotropic meds for all children has increased, the rate of use for those in foster care has grown even faster, the paper writes. 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,” Martin Irwin, a Syracuse, NY-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, tells the paper. “It’s out of control in general, but the worst problems are in foster care because there’s basically nobody advocating for the kid.”
In addition to the main story, there were several other stories in the series - Concerns over the future of foster kid health; Debate over the effect on young brains; parental consent issues; foster kid issue hasn’t received much scrutiny.
US Political News » Out Of Sight, Out of Mind: Psychtropics & Foster Care
[...] Read the rest of this great post here [...]
Nathan
Kids in foster care have generally been through very traumatic experiences, including violence at home, drug use by parents, death of parents, etc. It’s no surprise that these kids are likely to have much higher risk of depression, anxiety, and ADD. Does anyone think otherwise?
I’ll bet if you looked at adult victims of violent crime or adult victims of major disasters (9-11 and Katrina), you would also find much higher rates of psychotropic use.
However, two of the facts do concern me: 1) increased use of psychotropic in the very young and 2) the fact that 12% of the kids are on psychosis drugs.
Lisa Van S
Definitely used as a Chemical Straight Jacket…
According to Nami NJ’s Educating the Educators Brochure.I will quote them.
Part I- Physician Perspective:”The Biological Nature of Mental Illness”
“Mental Illnesses are Biological brain Disorders. They are not caused by poor parenting skills, or weaknesses of character. Learn the Facts and the fiction of chidhood-onset mental illnes.”
Did you notice that they state “Brain Disorders”,not “Diseases”
Absolutely amazing how this Group gives a “Free Ride” to abusive parents.But then again they have a financial interests. SEE HERE
http://www.namipharma.org
And NJ’s own Phil Lubitz:
http://www.pharmalot.com/2007/11/informed-consent-bill-on-psychotropics-dies-in-nj/
And not lets forget the incentives for Docs,free lunch and vacations, and how about those lovely Grants and Speaking Fees.
Lisa Van S
Nathan,
In the New Jersey Program for October 2006:
–More than 39,000 total Psychotropic drug prescriptions for chidren under
–647 prescriptions for children age 4 or less
–211 antipsychotics for children age 4 or less
including 174 prescriptions for Risperdal
–28 psychotropic drug prescriptions for children under 2
including 13 antipsychotics, 10 Benzos and 2 antidepressants
–19 psychotropic drug prescriptions for children under 12 mos. Including 3 antipsychotics
Even you have to admit that this is pretty sick..
Nathan
Lisa,
I can’t believe I’m saying this, but I agree with you. Those are very disturbing numbers. However, I’m not a physician. The responsibility for this rests with the childs physician. I can only hope the doctor has a really, really darn good reason for administering antipsycotics to a one-year-old. Where did you get these numbers? Are you sure they are accurate?
Lisa Van S
Yes, the numbers are accurate. Laurie had obtained the information from the state of NJ through a FOIA request.The raw data provides us with The County were it was prescribed, the name of the Physician along with his medical License#,age of the child,and name and dose of the drug, all drugs were paid through the NJ Medicaid Program, which means the Taxpayer foots the bill, Thats Me and You..
Laurie and I have provided the raw data to Pharmalot for verification.
Lisa Van S
Nathan,
In the case of Infants, Parents are just as much to blame as the physician. You have to ask yourself, what the Hell were they thinking. But, again, What did the Doc say to the parent?
Adriana
There are many more Robert Hawkins in production apparently.
Why can’t pharma just hold up Medicaid directorships at gunpoint and steal the money instead of using defenseless children as garbage drug depositories to justify the theft? And how does a hard life justify punishment by forced brain damage? Pharma’s own studies show non-drug treatments to be more successful and far-reaching than drugs.
All of these psychotropes, without exception, cause brain cell death. The side effect of apoptosis is euphoria, which may appear at first to make a child more pliant, before the tics, movement disorders, akathisia, hyperprolactinemia, psychosis and miriad of other side effects show up.
TOdd
Not disputing any of these facts, but I have been on a state’s DUR board. We looked into pts that were getting excessive doses, birth control pills used in boys, high doses of meds used in infants, meds used without a proper diagnosis, sex specific meds used in the wrong sex, etc.
What did we find? In almost 75% of these cases it was a clerical error or a legitimate reason for writing the drug. Possible problems include : Wrong coding in the pharmacy/physician office, wrong date entered for DOB, missing diagnosis code, wrong patient profile, convenient overbilling by the pharmacy, etc. So “raw numbers” don’t mean as much to me as those that have been thru the DUR process and examined. So you can provide the raw numbers for verification to Pharmalot, but Ed can only verify that those are the numbers you gave him. The DUR board could investigate for actual accuracy - not doable with HIPPA, even under FOIA. So I am not saying there is no way a 9 month old got a scrip for an antipsychotic but investigation needs to be done. I know in 1 case we examined an infant was getting Haldol (an antipsychotic) - on investigation it was being used to stop the hiccups that had been going for almost 1 month. So yes they were getting an antipsychotic, but short term to stop an different medical condition. Off label? yes, but I am not aware any meds labeled for treatment of hiccups are you? In this case after 7 days it worked. Again, sometimes the only thing you can try is off-label - and it worked. So I would question accuracy, diagnosis, etc.
Also keep in mind some meds are not covered by medicaid for “off-label” prescribing. So in the hiccup case, the physician might have even “miscoded” for psychoses to get covered without the hassle of prior authorization forms for off-label prescribing. Maybe they are using Wellbutrin for narcolepsy unresponsive to Provigil, etc. Who knows, the point is that unless you make the call and verify reading it off a sheet is not always 100% accurate. In our state it was about 25-35% accurate.
As far as the taxpayers footing the bill, you are aware that on average after rebate that the usual cost to medicaid programs is about AWP - 85%. So that works out to about $8-10 per Rx per month. That is not what is killing the taxpayers or healthcare system. In the US, drugs account for about 11% of healthcare costs, in medicaid that shrinks to about 5%. So that is not really a valid arguement as if you save 1 ER visit you have paid for the entire drug spend for that patient.
Again, not trying to debate the therapuetics, but the taxpayer angle doesn’t hold water, as well as the accuracy of pure raw numbers.
Adriana — Most studies I have seen show similar efficacy between talk therapy and drug therapy. Again going with the $10/month cost versus $150/hr for counseling it is hard to go against the economics if they appear equal. Otherwise the medicaid system would Also I assume you are talking about amphetamines when you mention brain damage. Is that correct? If you have seen where antipsych or antidepressants cause brain cell death please point me to that study.
But please everyone, lunches do not get scrips written. Neither do pens, sticky pads, widgets, or marketing crap. Now big speaking fees might bend someones judgement, but you don’t want to see them in the first place. Those docs only account for about 1 in 20 docs out there, and they are easy to spot and can’t write all of the scrips can they?
Nathan
Thanks for the insight Todd — it’s nice to see some firsthand experience. Those numbers are still disturbing, but they are a lot less disturbing in light of the points you raised.
AA
Nate,
You said:
>
Not to start a flame war but what about addressing the cause of their problems instead of automatic drugging everything. These conditions are horrific events in someone’s life that need compassionate help, and not drugging. Drugs should only be used in a dire emergency and only as a temporary basis.
How the heck did people who have so called psychiatric problems get sentenced to a lifetime on drugs?
I apologize for the rant but as someone who is tapering off of all psych meds and doing so much better, I shudder to think what would have happened to me if I had stayed on the meds. Apparently, a tremor I developed with occurred along with memory loss, was a sign of potential neurological damage. Yet, if I hadn’t made a move to get off these meds, I would have been kept on them.
Again Nate, I don’t mean for this to sound like an attack. But I still think you’re missing some points about this issue.
AA
TOdd
So Lisa/Laurie - get your numbers verified or are they raw numbers you are willing to stand up for? I will hand it to you, you are very smart. You do the best job of avoiding arguements you can’t win of anyone I know.
Lisa Van S
Todd,
Gee, your the Jack of all Trades. Nice Try….
Parenting And Child Care
Finding Reliable Home Daycares Run by Child Care Providers…
Cares and worries, abandon them for 6 — 12 blissful hours each day. Why? Because daycares have now been established in easily accessible locations. You will find these daycare centers in almost every state and neighborhood for the sole purpose of …