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Too Much Medication, Too Little Understanding

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It should go without saying children whose live within a chaotic/traumatic environment during the years of their core development are going to present a higher than normal likelihood of possessing one or more complex trauma related/mental health needs. Since the 90’s, doctors have turned to the use of “medical straightjackets” to reign in these “undesirable” behaviors our children demonstrate as a result of said environment. What I find shocking is that even with there being factual evidence that these medications have adverse effects as well as a lack of supporting evidence towards their efficacy in children, their use has steadily been on the rise. What's even more shocking is the realization that if a child has a home environment that is chaotic/traumatic enough to require removal, these children stand an even higher chance of being placed on medication because the rate at which children are being given mood altering drugs is higher for those involved in the welfare system.

Children in foster care are 9 times more likely to receive medications over other children involved in the Medicaid program even though these same children only account for 3% of the total children enrolled in the Medicaid program. There was a study conducted in 2008 that found children in the foster care system were being given at least one class of psychotropic drug at a rate of approximately 21%, were being given three or more at a rate of approximately 41%, and four or more at a rate of approximately 15%.

Too Many:
•Children living within the welfare system are dosed more often than other children with psychotropic meds as a way to treat possible emotional/behavioral issues while at the same time, little to no effort is made to assess and/or provide psycho-social treatments such as therapy or skills training.
•Some child Psychiatrists are aware there is NO evidence to support the efficacy of a child taking five or more of these drugs, yet prescriptions are still seen. In fact, since 2002, there has been an increase of 600% in children in the general population.

Too Much:
•Another area “red flag” is the dosing measure used. Since these drugs HAVE NOT been tested on children, very few provide any type of concrete dosing guidelines.
•Due to the absence of these guidelines, some states are and have put together their own expert panels to create them.

Too Young:
•In 2011, the GAO (Government Accountability Office) found in 5 states that children in foster care had higher rates of usage than other children enrolled in the Medicaid program combined in those states.
•Also found .3-2.1% of those children UNDER ONE YEAR OF AGE were taking psycho-active medications, such as Antihistamines and Benzodiazepines compared to the .2 to 1.2% not in foster care. Now for those who may not be aware, Antihistamines are used to treat allergy symptoms, but Benzodiazepines fall in the class of anti-anxiety drugs. This means while they are used a great deal to treat things like anxiety and insomnia, they are also used for muscle tightness, pre-surgical sedation, detoxification from alcohol and the anxiety experienced with cardiovascular or gastrointestinal conditions. Regardless of the reason prescribed, NEITHER of these medications is recommended to be taken longer than 7-14 days!

As parents our job is to love, educate, guide, and most importantly, PROTECT our children. Regardless of whether or not we are talking about a child in the foster care system or one residing with their family, there is more than enough information available that demonstrates there availability of effective and reliable treatments that can be used with children who suffer from trauma/mental health related disorders which do not rely solely on the use of psychotropic medications. Now there are times medication proves beneficial and at times, even necessary, but it should NEVER be the first line of defense nor should anyone rely upon it as a long-term solution.

As parents, we need to stop being afraid of doctors or offending them. We need to be asking questions as opposed to taking things at face value, even if it means getting a second opinion or even just saying no! We are our child's only voice and no one should know your child better than you. As professionals, we should be more than willing to give children the time, effort, and compassion they need to bring about change, especially considering that we are dealing with issues these children did not create themselves. Overall, until better testing and fact based results can be provided, those directly involved with these children have to be more aware, no matter what their role is.

For more information on this topic, you can find it in the following journal:
Administration on children, youth, and families, 2012, “too many, too much, too young:red flags on medications and troubled children". Reclaiming: children and youth Volume 21, issue 2, summer 2012

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