Tuesday, November 29, 2011

Quotes from Time Magazine about Overmedication of Foster Youth

Source: Szalavitz, Maia. Why Are So Many Foster Care Children Taking Antipsychotics?
Time Magazine, November 29, 2011.

  • "The influence of pharmaceutical company marketing cannot be overlooked. Ninety-nine percent of youth receiving anti-psychotic medications in the study were given atypical anti-psychotics — the newer generation of these drugs, which are expensive and mostly unavailable in generic form and have been heavily advertised.
  • "All of the major manufacturers of these drugs have been fined by the Food and Drug Administration for illegal marketing practices — in part, for marketing the drugs for unapproved use in children — with some convicted of criminal charges.
  • "The main condition that antipsychotics are approved to treat —schizophrenia — is extremely rare in children. The rate of schizophrenia in children under 12 is an estimated 2 cases per 1 million children; it affects fewer than 1% of older teens. Anti-psychotics are also approved to treat bipolar disorder, a diagnosis that is highly controversial in children. Some studies suggest that it affects 0.2% to 0.4 % of children, and up to 1% of adolescents.
  • And yet, between 1994 and 2003, rates of bipolar diagnoses in youth under 19 rose by a factor of more than 40, according to the National Institute on Mental Health. It seems unlikely to be a coincidence that this rise occurred during the period when atypical anti-psychotics were being illegally marketed for children."
  • "Indeed, most of the anti-psychotics used in foster-care youth were for conditions that the drugs were not approved to treat. Fifty-three percent of prescriptions were written for attention deficit/hyperactivity disorder (ADHD), a condition that is ordinarily managed with drugs that have the opposite pharmacological effects as anti-psychotics. The stimulant medications like Adderall and Ritalin, widely used for ADHD, tend to increase levels of dopamine, while anti-psychotics tend to decrease it."
"This study confirms the need for developmentally and trauma-informed practices in the vulnerable foster-care population," says Dr. Bruce Perry, founder of the ChildTrauma Academy. "Misunderstanding the pervasive effects of abuse and neglect leads to the mislabeling of behavioral and emotional symptoms in these children and then to overmedication."

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Overmedication of foster youth continues....

A new study, Antipsychotic Treatment Among Youth in Foster Care, examined concomitant antipsychotic use among Medicaid-enrolled youth in foster care, compared with disabled or low-income Medicaid-enrolled youth.

They found that:
  • More than a third of youth in foster care without disabilities had multiple anit-psychotic prescriptions lasting longer than 90 days
  • Children who were not adopted had the highest rates of prescriptions, representing 38 out of every 100 children in foster care.
In comparison, 26 out of every 100 children who were on public assistance but not in foster care had more than one antipsychotic prescription.

In recent years, doctors and policy makers have grown concerned about high rates of overall psychiatric drug use in the foster care system. Previous studies have found that children in foster care receive psychiatric medications at about twice the rate among children outside the system. 

In 2008, the House Ways and Means Subcommittee on Income Security and Family Support held a hearing on the utilization of psychotropic medication for children in foster care.

In 2010, Senator Daniel Akaka (D-HI) asked the Government Accountability Office (GAO) to investigate the prevalence of prescribed psychotropic medications for children in foster care.

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Monday, November 28, 2011

Valuing and Asserting Personal Worth vs. Maintaining Abusive Relationships

 "Describing how the brain changes in response to a child's experience, Bruce Perry wrote, 'Children are not resilient, children are malleable.' Trauma, neglect and abuse influence how synapses develop pathways, how neurons fire, how we translate incoming information...

"The baby learns how the caretaker will respond to his emotional needs, and from this, the baby begins generalizing his experiences and defines the world.

"The failure to consistently meet the infant's needs (emotional or biological) impacts the child's sense of self long before the pain influences her perception of the outside world. 'Unfortunately, the child will interpret this as a product of its own inadequacy,' J. Konrad Stettbacher notes.

"Dependent upon others for survival, the child believes that the cause of pain is his own self and he tries to adapt (they must be right; therefore, he is wrong). In response, he minimizes or relabels his own pain: 'It's not so bad.' Pain is always a signal that something has to change - how we respond to that pain reflects what we've learned early on.

"Similarly, the victim of emotional abuse things, 'If I were better, they wouldn't do this to me,' rather than, 'This other person is causing me pain and if she doesn't stop, she has to exit my life.'

"No infant has the ability to make that distinction - they blame themselves in order to hopefully fit the caregiver, alleviate the pain, and preserve that bond.

"Acknowledging pain is the vital first step in any self-defense. Acknowledging what 'hurts' identifies the boundaries that define each one of us... If a victim can decide whom to trust and then act on this decisions, (he or she will have) the resiliency to emotionally to defend himself...

"Resiliency acknowledges that there will be a cost. The former victim may lose a 'friend...'

"Doing so lifts the burden the victim assigned himself, but also presents a hard decision. To define one's self, there is a cost."

~ Heart Transplant by Andrew Vachss and Frank Caruso