The new camp checklist? Bug spray, shorts and pills

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http://www.iht.com/articles/2006/07/16/news/meds.php

 

 

 

The new camp checklist? Bug spray, shorts and pills

By Jane Gross The New York Times

 

Published: July 16, 2006

 

 

 

The new camp checklist? Bug spray, shorts and pills

By Jane Gross The New York Times

 

Published: July 16, 2006

BURLINGHAM, New York The breakfast buffet at Camp Echo starts at a

picnic table covered in gingham-patterned oilcloth. Here, children

jostle for their morning medications: Zoloft for depression, Abilify

for bipolar disorder, Guanfacine for twitchy eyes and a host of

medications for attention deficit disorder.

 

A quick gulp of water, a greeting from the nurse and the youngsters

move on to the next table for orange juice, Special K and chocolate

chip pancakes. The dispensing of pills and pancakes is over in

minutes, part of a typical day at a typical sleep-away camp in the

Catskills.

 

The medication lines like the one at Camp Echo were unheard of a

generation ago but have become fixtures at residential camps across

the United States. Between a quarter and a half of children at any

given summer camp take daily prescription medications, experts say.

 

Allergy and asthma drugs top the list, but behavior management and

psychiatric medications are now so common that nurses who dispense

them no longer try to avoid stigma by pretending they are vitamins.

 

" All my best friends take something, " said David Ehrenreich, 12, who

has Tourette's syndrome yet feels at home here because boys with

hyperactivity, mood disorders, learning disabilities and facial ticks

line up just as he does for their daily " meds. "

 

With campers far from home, family and pediatricians, the job of

safely and efficiently dispensing medications falls to infirmaries and

nurses whose stock in trade used to be calamine lotion and cough

syrup. Three times a day, at mealtimes, is the norm, with some campers

also requiring a sleep aid at bedtime to counteract the effect of

their daytime medications.

 

" This is the American standard now, " said Rodger Popkin, an owner of

Blue Stars Camps in Hendersonville, North Carolina. " It's not limited

by education level, race, socioeconomics, geography, gender or any of

those filters. "

 

Peg Smith, the chief executive officer of the American Camp

Association, a trade group with 2,600 member camps and three million

campers, said that about a quarter of the children at its camps are

medicated for attention deficit disorder, psychiatric problems or mood

disorders.

 

Many parents welcome the anonymity that comes when a lot of children

take this, that or the other drug, so none stand out from the crowd.

 

" It's nobody's business who's taking what, " said one parent of an Echo

camper whose child is medicated for attention deficit disorder, and

who asked not to be identified for privacy reasons. " It could be an

allergy pill. The way they do it now, he feels comfortable. He just

goes up with everybody else, gets it and then carries on with his day. "

 

Increasingly popular is a service offered by a private company named

CampMeds, which provides a summer's worth of prepackaged pills to

6,000 children at 100 camps.

 

The company's founder, Dana Godel, said that 40 percent of the

children regularly took one or more prescription medications, compared

with 30 percent four years ago.

 

Last year, 8 percent used attention deficit medications and 5 percent

took psychiatric drugs.

 

Borrowing technology developed for nursing homes, CampMeds distributes

pills in shrink-wrapped packets marked with a name, date and time.

 

Camp nurses simply tear each packet along the dotted line, sparing

them the labor-intensive task of counting pills and reducing the risk

of error and thus liability.

 

The proliferation of children on stimulants for attention deficit

disorder, antidepressants or antipsychotic drugs - or on cocktails of

all three - is not peculiar to the camp setting.

 

It is the extension of an increasingly common year-round regimen that

has also had an impact on schools, albeit a lesser one, since most

medications are taken at home.

 

Exacting diagnoses and proper treatments enable some children to go to

camp who otherwise could not function in that environment, said David

Fassler, a child and adolescent psychiatrist and a professor at the

University of Vermont College of Medicine.

 

Fassler said that children with one behavioral or mood disorder often

" have a second or even a third diagnosis. " A child with attention

deficit disorder may also be depressed and anxious, he said, a

combination of symptoms that can make such children pariahs in the

close quarters of a summer camp cabin without the proper combination

of remedies.

 

And many experts have said that family doctors who do not have

expertise in psychopharmacology sometimes prescribe drugs for anxiety

disorders and depression to children without rigorous evaluation, just

as they do for adults.

 

" There is no doubt that kids are more medicated than they used to be, "

said Edward Walton, an assistant professor of pediatrics at the

University of Michigan and an expert on camp medicine for the American

Academy of Pediatrics. " And we know that the people prescribing these

drugs are not that precise about diagnosis. So the percentage of kids

on these meds is probably higher than it needs to be. "

 

CampMeds charges $40 a child for any length of stay or for any

regimen, a cost that most camps pass along to families.

 

The Fresh Air Fund camps do not use CampMeds, but not because of cost,

said Jenny Morgenthau, the fund's executive director. She said many of

the families are too disorganized - some in shelters or in prison - to

do the preparatory paperwork.