Wednesday, February 20, 2013

Require pre-approval to prescribe psychotropic drugs to young children

This idea seems like a no-brainer to me.

About 49,000 prescriptions for antipsychotic and neuroleptic drugs are currently given to children under five years old through the Texas Medicaid program, many of whom are in foster care, state Rep. Sylvester Turner said yesterday in a hearing on HB 473. (Some of those represent multiple psychotropic drugs prescribed to the same child, so the total number of kids receiving the drugs is lower than that). Turner's bill would require pre-authorization for such prescriptions for very young children. In Illinois, according to one witness, similar pre-authorization is required up to age 8.

Chairman Richard Raymond suggested the drugs were being used as a substitute for parental "patience." A GAO study (pdf) from 2011 found that children in foster care are given psychotropic drugs at much higher rates than kids who are not.

The Texas Medical Association opposed the bill, arguing the decision should be left to doctors. Go here to watch the hearing; the bill was brought up at the 28:00 minute mark.

9 comments:

Soronel Haetir said...

I would expect that kids in foster care would have a higher rate of problems of all kinds, they are coming from a population where the parents already have problems so it should be no surprise if the kids do as well.

Gritsforbreakfast said...

I mentioned the GAO study about foster care because it was discussed at the hearing, but just to be clear: The bill applies to any kids on Medicaid under 5 who're prescribed psychotropic drugs, not just foster kids.

Anonymous said...

This has been an issue for more than a decade. It is brought back up every once in a while but nothing really changes. I worked for CPS, a private foster care agency, and a residential treatment center, all more than 10 years ago. The way the doctors handed these drugs out like candy then bothered me. A psychiatrist typically spends about 15 minutes with the child. These drugs have many side effects with some being very dangerous. I think what sometimes happened is a child might exhibit a new problem, or worsening of a problem, that was actually caused by the meds. Instead of considering the possibility, the doctor would just prescribe an additional medication to deal with that problem. You would end up with these kids on several medications and I don't think anyone really knows how they really interact.

There are a few factors that, I think, explain why this continues to be an issue. First, the drug companies want as many people as possible using their product and they have a significant influence over psychiatrist. Second, many psychiatrist know very little about other treatment methods and don't want to know. It's easier just to spend 15 minutes with a person and write a prescription. At that pace you can see a lot of patients in a day and make a lot of money. Other treatment methods would likely be more time consuming and not result in the same profits. Third, to deal with the children that are placed in residential treatment centers due to behavior issues without medication would require more staff and better trained staff thus raising the cost. Its cheaper to medicate them and leave it to them to deal with any long term side effects once they are no longer the state's problem.

Prison Doc said...

Use of drugs as "chemical restraints" is a rampant and despicable problem, and anything that slows it down should be salutary.

Anonymous said...

It's funny that you brought this up because just this morning I was watching HLN and they were reporting on a national trend of parents, not kids, being prescribed Xanax and antidepressants and a survey found many of these parents had more success bringing up troubled or otherwise challenging kids.

I'm like "what??" I can see where troubled kids would wear down a mother, but let's face it; there is no substitution for good ole fashioned values. Drugs don't fit in that equation unless there is a neuropsychiatric problem caused by genetics or trauma.

benbshaw said...

Here is an article in the Huffington Post on that subject:

http://www.politicsdaily.com/2010/06/17/psychotropic-drug-abuse-in-foster-care-costs-government-billions/

Here is a conservative take on the relationship between the Bush family and mandatory mental health screening.

http://www.conservativeusa.net/mentaltesting.htm

Anonymous said...

These drugs are prescribed more for controlling people than helping them. Let's at least put some brakes on prescribing these drugs to our youngest and most vulnerable children. I read that psychotropic drugging of foster children is common in Texas.

wwdovew said...

Drugging children in foster care is billions of bucks nationwide! Any child removed even for a day from their family suffers emotional distress and then the system begins to fill them with all kinds of drugs....DUH!....what did they expect? Over 80% of children removed from families did not have to be removed. Child Protective Service is a business that funds itself by removing children using false allegations in the majority of cases. The states receive money from Social Security Title IVE. For every child put into foster care, the state receives this funding and if they adopt that child to a stranger family (not a relative family), the states make bonuses. This funding continues until the child is age 18 or even until the age of 21

James Rinkevich said...

When I was a foster parent we had a child who had been placed in an adoptive home and then was abused by one of the children there, so he was removed and they were trying to finish the paperwork and training for a relative to take him. We were concerned about the abuse, and wanted to get him treatment, but the best we could get for him was some group therapy because the court restricted the agency from having him given psychotropic meds without its permission.