Over-Medicated Kids in Foster Care Get Some Relief

By Zachary Siegel 07/02/15

California addresses the startling trend of medicating young children in foster care.

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There is a growing concern that kids in foster care are inundated with psychiatric medication, which is why California's Legislature passed four bills into law making it much more difficult for children in foster care to be put on psychotropic drugs.

California State Senate Committee on Human Services reported that nearly one in four adolescents in foster care are on some form of psychotropic medication, and 56% are on medications in general.

Even more troubling, the California Senate committee reported, 60% of those that were on medication were prescribed anti-psychotic drugs. Antipsychotic drugs have notoriously uncomfortable side-effects, such as weight gain, confusion, and being overly subdued.

Many children also had multiple prescriptions, which can lead to medical complications, especially if doctors only spend 15 minutes with the child and don’t know the child’s background.

Such is often the case with foster children who experience cursory doctor visits without a parent’s active engagement in their health.

In response to this disturbing trend, four bills came to California’s Senate that specifically call for the following changes:

  • Strengthen the court authorization process to require clear and convincing evidence for any prescription and evidence that other treatments have been attempted prior to medications;
  • Provide for training, data collection, and systems to red-flag questionable practices;
  • Increase the oversight role of public health nurses to ensure that vital signs are monitored for all foster children prescribed psychotropic medications;
  • And identify the group homes that are most over-reliant on the riskiest psychotropic medication treatments and require these homes to develop corrective action plans that are monitored for progress.

Julie Zito, professor of pharmacy at the University of Maryland said, "We have a major problem and California has done us a great service in calling attention to this vulnerable population."

But the problem doesn’t end there, says Zito. “We over-medicate the poor, especially the most vulnerable, including foster care,” she said.

For better examples of oversight in the area of foster children, many look to Illinois, which has more advanced protocols for monitoring children in the foster system.

“In Illinois, our goal is not to increase the use of the drugs,” said Michael Naylor, director of the Division of Child and Adolescent Psychiatry at the University of Illinois at Chicago. “It’s not to decrease their use. It’s to figure out when it becomes appropriate to use them, and what the appropriate dosages would be.”

Zito is slightly more reticent than Naylor with respect to the use of medication at all. "I'm not suggesting these are not needy children." What Zito disputes, she said, is that medication has become the go-to solution for complex social problems.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.