America's Poor Kids On Antipsycho Drugs 01
From
Jeff Snyder@1:345/3777 to
All on Sat Dec 12 21:25:00 2009
The following NYT articles confirms something which I have suspected for
quite a while now, and that is that there are many school-aged children in America who are being given powerful antipsychotic drugs when they really
don't need to be taking them.
While this article points the finger at parents who are desperate for any solution to their child's problems, as well as at doctors and psychiatrists
who are too quick to prescribe such dangerous drugs, I think that this
article still misses the mark, because it doesn't ask a simple basic
question, and that is this: Who is profiting from all of this?
The answer in my mind is very clear: the pharmaceutical industry! Those
drugs are not free; someone has to pay for them; and if not the parents,
then the local or federal government. But regardless of who pays for them,
it is the pharmaceutical industry which profits from it all.
The fact that four times as many low-income children are being given these powerful drugs compared to children in the higher income brackets, is very telling. It tells me that the pharmaceutical industry has found an easy, profitable market in low-income families, and it is milking these poor
people for all they are worth.
In my mind, this is no different than the U.S. military filling its ranks
with low-income and disadvantaged teenagers. It is the very same strategy.
It is an easy fishing pond.
What I also find alarming is how lightly some of these doctors view this situation. One psychiatrist in this article blithely states "If it [giving
them drugs] helps keep them in school, maybe it's not so bad."
Not so bad??? My gosh! How can she think like that?! They are knowingly
raising a generation of kids who are becoming dependent on these powerful drugs, even to their own hurt. I find this attitude unprofessional,
deplorable and inexcusable.
When I was a kid decades ago, we had the same problems in the schools. Maybe they weren't quite as severe as they are today, but they did exist. In spite
of that fact, kids were not being prescribed antipsychotic drugs left and
right like they are today. To my knowledge, is was basically unheard of back then.
So what has changed? Why do so many children -- particularly poor children
-- all of a sudden need to be taking these dangerous behavioral drugs? The point is, as I have already stated, many of them don't need to be taking
them. I remain convinced that it is simply the greed of the unscrupulous pharmaceutical industry which has resulted in this current deplorable situation. Furthermore, I really have to wonder what some of these doctors
and psychiatrists have to gain by being so quick to recommend these drugs in the first place. Do they possibly have connections to the pharmaceutical industry, or perhaps some cozy business arrangement?
Following is the article from the New York Times.
Poor Children Likelier to Get Antipsychotics
By DUFF WILSON - NYT
December 11, 2009
New federally financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate
four times higher than children whose parents have private insurance. And
the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows.
Those findings, by a team from Rutgers and Columbia, are almost certain to
add fuel to a long-running debate. Do too many children from poor families receive powerful psychiatric drugs not because they actually need them --
but because it is deemed the most efficient and cost-effective way to
control problems that may be handled much differently for middle-class children?
The questions go beyond the psychological impact on Medicaid children,
serious as that may be. Antipsychotic drugs can also have severe physical
side effects, causing drastic weight gain and metabolic changes resulting in lifelong physical problems.
On Tuesday, a pediatric advisory committee to the Food and Drug
Administration met to discuss the health risks for all children who take antipsychotics. The panel will consider recommending new label warnings for
the drugs, which are now used by an estimated 300,000 people under age 18 in this country, counting both Medicaid patients and those with private
insurance.
Meanwhile, a group of Medicaid medical directors from 16 states, under a project they call Too Many, Too Much, Too Young, has been experimenting with ways to reduce prescriptions of antipsychotic drugs among Medicaid children.
They plan to publish a report early next year.
The Rutgers-Columbia study will also be published early next year, in the peer-reviewed journal Health Affairs. But the findings have already been
posted on the Web, setting off discussion among experts who treat and study troubled young people.
Some experts say they are stunned by the disparity in prescribing patterns.
But others say it reinforces previous indications, and their own experience, that children with diagnoses of mental or emotional problems in low-income families are more likely to be given drugs than receive family counseling or psychotherapy.
Part of the reason is insurance reimbursements, as Medicaid often pays much less for counseling and therapy than private insurers do. Part of it may
have to do with the challenges that families in poverty may have in consistently attending counseling or therapy sessions, even when such help
is available.
"It's easier for patients, and it's easier for docs," said Dr. Derek H.
Suite, a psychiatrist in the Bronx whose pediatric cases include children
and adolescents covered by Medicaid and who sometimes prescribes antipsychotics. "But the question is, 'What are you prescribing it for?'
That's where it gets a little fuzzy."
Too often, Dr. Suite said, he sees young Medicaid patients to whom other doctors have given antipsychotics that the patients do not seem to need. Recently, for example, he met with a 15-year-old girl. She had stopped
taking the antipsychotic medication that had been prescribed for her after a single examination, paid for by Medicaid, at a clinic where she received a diagnosis of bipolar disorder.
Why did she stop? Dr. Suite asked. "I can control my moods," the girl said softly.
After evaluating her, Dr. Suite decided she was right. The girl had
arguments with her mother and stepfather and some insomnia. But she was a
good student and certainly not bipolar, in Dr. Suite's opinion.
"Normal teenager," Dr. Suite said, nodding. "No scrips for you."
Because there can be long waits to see the psychiatrists accepting Medicaid,
it is often a pediatrician or family doctor who prescribes an antipsychotic
to a Medicaid patient -- whether because the parent wants it or the doctor believes there are few other options.
Some experts even say Medicaid may provide better care for children than
many covered by private insurance because the drugs -- which can cost $400 a month -- are provided free to patients, and families do not have to worry
about the co-payments and other insurance restrictions.
"Maybe Medicaid kids are getting better treatment," said Dr. Gabrielle
Carlson, a child psychiatrist and professor at the Stony Brook School of Medicine. "If it helps keep them in school, maybe it's not so bad."
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