Shocking reports of overmedicated foster children force government review

Three years ago, Mirko and Regina Ceska of Crawfordville, Florida, told former Gov. Charlie Crist their two adopted 12-year-olds had been prescribed 11 pills a day, including the powerful antipsychotic Seroquel, reported the Tampa Bay Times.

“These girls were overdosed and would fall asleep right in front of us several times a day,” Mirko Ceska told Crist at an “Explore Adoption Day’’ event. “It seems to be a prerequisite for foster children to be on medication,” said Ceska, calling the pills “chemical restraint.”

The couple’s remarks came on the heels of the suicide of Gabriel Myers, a 7-year-old in Florida foster care who was prescribed psychiatric drugs, including Symbyax, not approved for children because of links to suicidal thinking. More than 15 percent of 20,000 foster care children in Florida are medicated, says the Times and doctors and case managers treating medicated 6- and 7-year-olds “routinely failed to complete legally required treatment plans, share information or properly document the prescribing of powerful psychiatric drugs.”

Now, less than a year after passage of the Child and Family Services Improvement and Innovation Act which sought to improve protocols for psychotropic medications in children, three government agencies—the Administration for Children and Families, the Center for Medicare and Medicaid Services, and the Substance Abuse and Mental Health Services Administration—are convening a meeting with hundreds of state officials to address medication guidelines on August 27 and 28.

“This is an urgent issue, and child-centered organizations and individuals need to let state and federal administrators, Congress and state legislators know that it needs immediate action,” says Edward Opton, a psychologist and lawyer involved in child welfare issues. “The medical literature shows no studies of the long-term effects of antipsychotic drugs on children, including drugs for so-called conduct disorder, the condition for which they are most frequently prescribed to children. There are no data on drugged vs. undrugged children with respect to completion of school, employment, early pregnancy, imprisonment, or subjective quality of life as evaluated by the children or by anyone else.”

Both private and public youth facilities have been plagued with scandals. One large provider, Universal Health Services Inc., known as the “Standard Oil of mental illness,” recently agreed to pay $6.85 million to the U.S. and the state of Virginia to settle allegations that its Keystone Marion Youth Center provided “substandard psychiatric counseling and treatment to adolescents in violation of Medicaid requirements, falsified records and submitted false claims to the Medicaid program.” It chose to close the youth center.

There were two suicides in the Illinois Department of Juvenile Justice’s system of eight facilities between September 2008 and September 2009 and a follow-up report disclosed that a full 98 percent of the children are on psychoactive drugs.

Like the elderly in state care, children in state care prove tempting targets for both disreputable operators and Big Pharma because they do not make their own medication decisions, they are covered by public funds and the designation of behavioral problems in such settings is seldom questioned. Profit schemes often involve expensive antipsychotics like Seroquel, Zyprexa, Risperdal and Geodon whose safety and efficacy are in dispute, especially in children and the elderly.

In 2007, Bristol-Myers Squibb settled a federal suit for $515 million charging that it illegally hawked the antipsychotic Abilify to children and the elderly, bilking taxpayers.

The next year, the state of Texas charged Johnson & Johnson subsidiary Janssen with defrauding the state of millions with “a sophisticated and fraudulent marketing scheme,” to “secure a spot for the drug, Risperdal, on the state’s Medicaid preferred drug list and on controversial medical protocols that determine which drugs are given to adults and children in state custody.”

Soon after, Idaho, Washington, Montana, Connecticut, California, Louisiana, Mississippi, New Mexico, New Hampshire, Pennsylvania, South Carolina, Utah, West Virginia, Arkansas and Texas took Big Pharma to court over the antipsychotic spree.

When, during the same time period, the state of Florida began requiring doctors to get approval for high priced antipsychotics before giving them to kids under age six on Medicaid, more evidence of overmedication emerged: prescriptions for the pills dropped from 3,167 in 2007 to 844 in 2008, reported the Tampa Bay Times.

Martha Rosenberg’s top selling health policy book, Born with a Junk Food Deficiency, was released in April by Prometheus Books.