Preschoolers put on 'adult' medication

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Wed, 26 Apr 2006 02:52:11 -0000

[sSRI-Research] Preschoolers put on 'adult' medication. For

your IMMEDIATE attention: TeenScreen - Ohio - Please Respond

 

 

 

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Promoting Openness, Full Disclosure, and Accountability

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FYI

 

In the U.S. the two populations at greatest risk of inappropriate,

coercive, dangerous prescribing of highly toxic psychotropic drugs as

chemical restraints are the elderly and children. In both cases the

incentives, thanks to pharmaceutical industry influence,

reimbursement schedules favor drugs and drugs only: " The way our

mental health policy and reimbursement is organized right now, there

just are not incentives to work with children in impoverished

conditions. "

 

Below, The Portland Tribune reports that a study examining Oregon's

Medicaid plan found that 246 preschool children are being drugged

with toxic antipsychotics and / or antidepressants. The drugs are

unapproved for use in children under 18, and they carry black box

warnings of lethal risks.

 

However, parents never see those warnings.

 

When confronted with the evidence-essentially medical malpractice-

mental health " authorities " are squirming under the light being

shined on them:

 

The author of the Oregon study, psychiatry professor David Pollack,

acknowledges: " I know enough about clinical practice to know that

it's really hard to make diagnoses in children, and there's a lot of

pressure. "

 

He said he understands that " at first glance, the prospect of

children age 5 and under receiving psychiatric medication intended

for adults can be startling. " While conceding, " There's an element of

alarm, " he claims, " It doesn't mean it's inappropriate. "

 

And Dr. Joan Luby, a leading proponent of diagnosing preschool

children with bipolar disorder-an aberration in medicine applied

exclusively to U.S. children despite the acknowledgement by Dr.

Pollack: " it's really hard to make diagnoses in children. " On the

other hand, by labeling children bipolar psychiatrists provide the

appearance of legitimacy for prescribing antipsychotic drugs for

children off-label, without FDA approval.

 

Dr.Luby feigns ignorance about the widely reported incontrovertible

findings about the hazards of these drugs. " There's just not much

known. That doesn't mean these drugs aren't effective. We just don't

have the studies to show whether they are safe and effective. "

 

Has she not kept abreast of the incontrovertible findings of

government sponsored research (CATIE study) conducted by leading

psychiatrists who acknowledged that antipsychotic drugs pose severe

risks and their efficacy is undemonstrated.

 

" the side effect outcomes are staggering in their magnitude and

extent and demonstrate the significant medication burden for persons

with schizophrenia.. Sky-high drug discontinuation rates were seen,

suggesting rampant drug dissatisfaction and inefficacy. "

[see: Dr. Carol Tamminga, " Practical Treatment Information for

Schizophrenia " Editorial, American Journal of Psychiatry, April,

2006, vol. 163:563-565.]

 

In light of the evidence Dr. Luby's statement is worse than

disingenuous.

 

McNight's Long-Term Care Assisted Living News reports that a long-

range study shows nursing home residents are being killed by

overdoses of prescribed drugs at a rate increase of 179% in 10

years. " Opioid pain relievers, including codeine, morphine and

Demerol caused the majority of prescription drug overdose

deaths....Nursing home residents typically use multiple different

prescription drugs at one time. "

 

 

Contact: Vera Hassner Sharav

212-595-8974

veracare

 

 

http://www.portlandtribune.com/archview.cgi?id=4841

 

The Tribune

 

Preschoolers put on 'adult' medication

Study: 246 kids in Oregon Health Plan use drugs not tested for

children

 

By PETER KORN

 

Issue date: Fri, Apr 14, 2006

 

A new study directed by an Oregon Health & Science University

professor has found that 246 preschool children covered by the state-

sponsored Oregon Health Plan are receiving antipsychotic or

antidepressant medications that have never been studied for use in

children.

 

And while the study's lead researcher admits the figure might seem

alarming, mental health experts caution that the prescriptions might

have been justified and may be a result of Oregon's insufficient

mental health resources.

 

The study, a collaboration between the state's department of human

services, its Medicaid program and the Oregon State University

College of Pharmacy, was headed by OHSU psychiatry professor David

Pollack. Pollack said he understands that at first glance, the

prospect of children age 5 and under receiving psychiatric medication

intended for adults can be startling.

 

" There's an element of alarm, " he said. " But it leads us to say we

need to answer more questions. It doesn't mean it's inappropriate. "

 

Pollack noted that the 246 children represent less than one-half

of 1 percent of the 86,828 Oregon Health Plan children whose records

were reviewed. The Oregon Health Plan is an insurance program for low-

income Oregonians funded through Medicaid.

 

" The problem is there's very little data to direct the use of

pharmacological agents in preschool children, " said Joan Luby,

associate professor of child psychiatry at Washington University

School of Medicine in St. Louis. " There's just not much known. That

doesn't mean these drugs aren't effective. We just don't have the

studies to show whether they are safe and effective. "

 

Still, Luby, who has spent a decade studying children under 6

years of age, said that mental illnesses such as depression occur in

the very young more frequently than most people realize. " I wouldn't

say I'm surprised, but the public is surprised, " she aid. " Depression

is a disorder that's a good example of a combination of biological

and psychological risk factors. It's a complicated equation. "

 

A third of kids were abused

 

The Oregon study, first reported in a monthly publication called

Oregon Health News, looked at Medicaid pharmacy prescription records

from Oregon Health Plan claims. Among its findings: 41 percent of the

children given psychiatric medication had an attention deficit

disorder (though the prescribed medications were not those usually

recommended for children with the disorder), and 33 percent were

diagnosed victims of child abuse.

 

But the study, Pollack said, poses as many questions as answers.

Among them: Whether the children were adequately assessed before

being medicated, and whether the prescriptions were accompanied by

appropriate therapy. Pollack said he thinks data showing 82 of the

246 children given the drugs had suffered some form of abuse might be

particularly revealing.

 

" I know enough about clinical practice to know that it's really

hard to make diagnoses in children, and there's a lot of pressure, "

Pollack said. " You have some very complex cases where children might

have some combination of illnesses, developmental disabilities and

autism. "

 

'You're out on the front line'

 

One of the questions Pollack would like answered, but which

pharmacy records don't address, is: " How much pressure was the

prescriber experiencing from whomever? "

 

" A lot of cases are where they're trying to keep the child from

being placed outside the home, " he said. " This was a study of

Medicaid children. A lot of these kids may have had some involvement

with child protective services or some other protective services

agency. "

 

Sometimes, Pollack said, medication may be seen as the only way to

keep a child with behavioral problems in the home.

 

Luby agreed that the Medicaid status of the children in Pollack's

study could play a role in the prescriptions: " You're out on the

front line and you have kids coming into your office with serious

psychiatric symptoms, even that young, and you often have

restrictions of care to the extent that it's not feasible or

affordable for nonmedication therapy to be done. " Ideally, Luby said,

therapy takes place for children before medication is

considered. " Psychotherapy is the first option, " she said. " With

Medicaid kids, there's no resources. There aren't providers who will

take Medicaid.

 

If there are providers who will take Medicaid, they often have very

overburdened caseloads. It's not possible to get psychotherapy on

Medicaid, or it's extremely difficult. And you need clinicians with

expertise treating young children.

 

" For people who have limited resources, sometimes medication might

be offered first for kids with disruptive problems, even if

psychotherapy might be the more appropriate treatment, " she said.

 

Incentives go missing

 

Christopher Thomas, director of child and adolescent psychiatry at

the University of Texas medical branch at Galveston, said that

economic status might play two roles in the lives of children

receiving psychiatric medication. " The way our mental health policy

and reimbursement is organized right now, there just are not

incentives to work with children in impoverished conditions, " Thomas

said. " And we know that poverty increases the risk for mental illness

in children. "

 

Lynn DeBar, a Portland psychologist with Kaiser Permanente's

Center for Health Research, who studied preschoolers as part of a

study three years ago, said most of the preschool children she found

who had received psychiatric medication truly needed the help.

 

" Kids who were medicated - they were kids that were highly

aggressive, that were engaged in behavior that was dangerous to

themselves and to other people, " DeBar said. " The concerns really

were that not having some kind of treatment would put them in more

jeopardy. "

 

Email peter korn

<http://www.portlandtribune.com/continfo.cgi?to=3%20peterkorn%2066>

 

 

 

http://www.mcknightsonline.com/content/index.php?id=$ & tx_ttnews

[tt_news]=) 12 & tx_ttnews[backPid]==3 & cHash=[2332e1f5

 

Study: Prescription drug overdoses surpass deaths from illegal drugs

 

April 25 2006

 

The death rate from accidental overdoses involving prescription

medications jumped 179% in 10 years. It now tops the rate of deaths

caused by overdoes of illegal drugs such as cocaine and heroin,

according to a new long-range study. Opioid pain relievers, including

codeine, morphine and Demerol caused the majority of prescription

drug overdose deaths, according to a 10-year study. The results

indicate that greater overdose prevention efforts should be

targeted at this group of drugs, said lead researcher Mark Mueller, an

epidemiologist with the U.S. Centers for Disease Control and

Prevention.

 

Nursing home residents typically use multiple different prescription

drugs at one time.

 

Between 1994 and 2003, accidental prescription drug overdoses

increased from

1.9 out of 100,000 deaths to 5.3 per 100,000 deaths. Unintentional

overdose deaths caused by illegal drugs increased 121% over the 10-

year period.

 

 

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Drug-Free School Zone? Just Say NO to Prozac for Children.