Stop drugging foster kids into a stupor

A report that came out this week said children in foster care are being prescribed powerful psychotropic drugs at 2.7 to 4.5 times the rate of children who aren't in foster care and they are being given in much higher doses.

One child quoted in the Associated Press story was given more than 20 drugs during the time he was in foster care and was once on five drugs at one time. Once he was adopted, his new parents took him off all of the drugs.

Another child was on two powerful drugs for attention deficit hyperactivity disorder when she was adopted from foster care and was put on ever more powerful drugs as her new parents kept taking her back to a mental health center for help with her behavior problems.

"She twice tried to kill the family dog, pulled skin off her nose and wiped blood on the walls, threw tantrums as doctors plied her with more than a dozen medications over the years, her mother said. "Her hands would just shake insanely and they would tell us, 'oh that's just her'. But it wasn't her. It stopped once she went off the medication," he mother said.

Once the girl received specialized help and was weaned off all but one of the drugs, her behavior improved dramatically and she was like a different child, her mother said.

"Some of the drugs have "black box" label warning for children's safety and are not approved for use by young children," according to the AP story. "But doctors often prescribe them off label. The drugs affect the central nervous system and can change behavior or perception. They are prescribed for depression, anxiety, schizophrenia and other psychiatric conditions. Little is known about the long term side effects of the drugs and drug, experts said." While some kids probably do have mental health issues that require this medication, many do not.

This shameful state of affairs appears to be in part due to a severe shortage of psychiatrists. The parents of the troubled little girl were confronted with a nine month long waiting list when they tried to get her in to see a psychiatrist. More of these kids are being seen by primary care physicians who prescribe powerful psychotropic drugs without dealing with the child's underlying problem. Foster parents demand that children with behavior problems be medicated and the underlying problems aren't dealt with as they ideally should be, with talk therapy and behavior modification at school and at home and a stable living situation.

According to the AP story, "federal health officials notified state child welfare leaders they will have to provide more details about how they control the medications for foster kids starting next year." That's a start, but I think it would also make a good deal of sense to look closely at reform of the foster care system.

I have to wonder how many of these kids are being drugged into a stupor because they are naturally angry and depressed about being taken away from their parents and everything they know? Foster parents are probably a lot less likely to put up with kids with behavior problems than a biological family that has blood ties and history with that child from birth.

Kids in foster care are usually there because of abuse and/or neglect in their homes. In some cases, especially cases of physical neglect, I strongly suspect that these children would be better off if they are left in their own homes, however imperfect. Programs that can provide support to parents and teach them how to be better parents have been used effectively to keep kids from going into foster care. Foster care should be a case of last resort, used only when it protects a child from serious harm. Once those few children are in foster care, they have a right to decent medical care and should not be drugged into compliance to make things easier on the rest of us.

We have an obligation to do better by them.