Some Texas foster kids' doctors have drug firm ties

Sunday, August 17, 2008

By Emily Ramshaw / The Dallas Morning News

AUSTIN – One in three Texas foster children has been diagnosed with mental illness and prescribed mind-altering drugs, including some that the federal government has not approved for juveniles, state records show.

Many of these drugs are prescribed by doctors who have a financial stake in pharmaceutical companies' success, a Dallas Morning News investigation has found. Dozens of physicians who treat children in state custody supplement their salaries with tens of thousands of dollars in consulting and speakers' fees, and they use drug company grants to fund their research projects.

Accepting this money is not illegal, nor is it frowned upon in most medical circles. Many of the state's leading medical experts receive income or grants from drug companies, money that has funded groundbreaking scientific advances. And financial ties between doctors and pharmaceutical firms are frequently self-reported by physicians on their Web sites, conference programs and journal articles.

But while the psychiatric drugs given to foster children cost millions of taxpayer dollars a year, it's hard to know how much the doctors prescribing them are making from pharmaceutical companies. Texas, like most states, does not require disclosure.

The most prominent researchers can easily make $15,000 a year from each drug company they consult for, plus fees for speaking engagements that top $1,500 an event, according to financial disclosure forms some researchers are required to file because they work for state universities. Research grants often exceed $100,000, these records show.

Texas health officials say the overwhelming majority of these doctors have dedicated their careers to improving the mental health of foster kids, who have far higher rates of mental illness than the average child. They sacrifice time that could be spent on private-insurance patients, for whom doctors say they are paid more.

And officials say there are strict and effective rules to ensure that doctors' relationships with drug companies don't affect their prescriptions, including a ban on enrolling foster children in most clinical trials and guidelines on which drugs they should prescribe. A new health management policy was implemented this year to help oversee children's doctors' appointments, medication and health records – all of which state officials say will continue to curb unnecessary prescriptions.

Concerns about how much children in state custody are medicated continue, though. Some advocates have reported cases of multiple drugs being prescribed by doctors who weren't psychiatrists or pediatricians, and who spent less than 10 minutes examining their young patients. Foster care providers, who, until recently, had poor access to children's full medical records, are often the ones seeking the treatment for troubled children.

A brother lost  

Wellbutrin for depression. Trazodone for insomnia. Paxil for anxiety. And Adderall for hyperactivity. That was teenager Kristie Garcia's daily regimen in 2001, months after white CPS vans pulled up to take her and her five siblings away from their suicidal father.

Days after she arrived at a campus that housed dozens of foster kids, Ms. Garcia received a routine psychiatric evaluation. Homesick, angry and miserable, she answered hundreds of questions from doctors whose names she no longer recalls – then swallowed every pill her care providers gave her.

At first, she slept all the time. When the exhaustion and constant fogginess gave way to strange voices in her head, Ms. Garcia said, she asked staff to take her off the drugs. They said no and told her if she refused them, she would be banned from swimming or watching movies.

As soon as she turned 16, Ms. Garcia got out of foster care and took herself off of the drugs. But her relief was short-lived. In late 2005, she learned that her little brother was dead – the result, autopsy reports show, of either suffocation or a heart attack while being restrained in foster care.

Toxicology reports show that Christening "Mikie" Garcia had four drugs in his bloodstream: an attention deficit medicine, an antidepressant, a mood stabilizer and an antipsychotic not federally approved for use in children. The drugs did not appear to reach toxic levels.

Authorities deemed the 12-year-old's death accidental, and the employee who restrained him was not charged with a crime.

"He didn't need any meds. He was the kind of kid who if someone had just threatened to call his mother, he probably would've stopped what he was doing," Ms. Garcia said, kneeling in a Kerrville cemetery to pull fistfuls of weeds from Mikie's grave. "I understand drugs for high blood pressure, for diabetes. But I know Mikie and I didn't need emotional stabilizers to live our lives."

No strings attached?  

Many pharmaceutical companies fund studies and conferences with no strings attached, meaning they don't have control over outcomes or content. And drug companies don't pay doctors by the number of prescriptions they write – evidence, physicians say, that they aren't improperly influenced in the treatment of their patients.

Researchers say that doctors with the best reputations are the most sought out by major pharmaceutical firms.

"The people who are most respected are the ones who talk to drug companies, who become consultants for multiple companies, because their opinion is really valued," said Dr. Lawrence Ginsberg, whose Houston clinic has prescribed psychiatric drugs to nearly 2,000 foster children since 2002, according to state Medicaid records.

Dr. Ginsberg, an expert whose work has been published in various top medical journals, has consulted for nearly 20 pharmaceutical firms throughout his career.

"We prescribe the medication that works best for the patient irrespective of our relationship with a drug company," he said. "If a physician talks to all the companies and prescribes for all the companies, then no company has an edge."

States that require doctors who write prescriptions to foster children to report their financial arrangements have found evidence that their work can be affected.

In Minnesota, more than a third of the state's psychiatrists were found to take money from drug companies. A review of that state's data by The New York Times last year found that psychiatrists who received at least $5,000 from drug companies that make new antipsychotic drugs wrote three times more prescriptions to children than doctors who didn't receive the funding.

In Vermont, drug companies gave more to psychiatrists in 2007 than to doctors in any other field. Eleven psychiatrists received an average $57,000 each. Other national studies have shown that researchers who are on pharmaceutical company payrolls are more likely to report positive findings when reviewing those drugs.

Although such entanglements are common in the medical industry, they are increasingly raising concerns about improper influence.

This summer, The New York Times reported that three prominent Harvard University researchers responsible for discovering bipolar disorder in children – and for treating it with psychiatric drugs – were found to have failed to report a combined $3.2 million in income from drug companies to their university. Between 1994 and 2003, the number of children diagnosed with bipolar depression increased 40-fold, and the sales of the drugs used to treat it doubled.

Now an influential senator is asking that the American Psychiatric Association reveal its own financing. In 2006, the drug industry made up 30 percent of the association's $62.5 million in funding. Many mental health associations have also acknowledged accepting large sums from drug companies.

Collaborations between researchers and pharmaceutical firms are essential to the development of groundbreaking treatments and are painstakingly monitored to remove even the appearance of improper influence, said Ken Johnson, the senior vice president for the Pharmaceutical Research and Manufacturers of America, the advocacy group for the country's drug research and technology companies.

Mr. Johnson said in a written statement that clinical trials and research grants are designed and implemented with the oversight of the Food and Drug Administration and independent review boards "in order to ensure that the data procured is as reliable and accurate as possible."

"Clinical research is a critical element in the development of revolutionary medicines that help patients live longer, healthier lives," Mr. Johnson said.

Gwen Olsen, a drug industry watchdog, says drug companies are often holding the strings. She said she spent 15 years as a pharmaceutical sales rep trying to influence psychiatrists by minimizing drug side effects, sidestepping safety questions, and using marketing materials doctored to water down negative studies.

"You could take statistics and bar charts and make them look pretty much how you wanted them to," Ms. Olsen says in a video interview linked from her Web site, www.gwenolsen.com. "I saw firsthand several circumstances where my minimization of side effects or misinforming a physician had actually resulted in the patient being damaged and/or killed."

Ms. Olsen, who could not be reached for comment, came forward after her 20-year-old niece who had been taking Paxil committed suicide, according to published reports – first attempting to hang herself from a ceiling fan, then setting herself on fire.  

How it works  

All children entering Texas' foster care system get a routine health screening, and any who show symptoms of mental illness receive psychiatric evaluations. Until this year, the doctors who performed those exams were chosen by individual foster parents, caseworkers or the directors of residential treatment providers – the only stipulation being that they accepted patients on Medicaid.

Child-welfare watchdogs say these doctors, many of whom were in private practice or affiliated with private mental hospitals, operated for years with little oversight. Short on time and swamped with patients, some rarely spent more than a few minutes with their foster patients, they said, and relied on drugs instead of more time-consuming behavioral therapy.

Often, children missed doctors' appointments and doses of medicine – the result of poor record-keeping as they were shuttled between foster families and facilities.

In April, the state implemented a new health care system for foster children, one that makes appointments and selects doctors for them using a standardized list. Under the new program, any children with diagnoses other than minor depression or attention deficit hyperactivity disorder must be seen by a child psychiatrist. The system also keeps track of all the children's medical records, creating a "continuity of care."

Despite the heightened regulations, however, many of the doctors on the list are the same as were seeing many foster children before.

Texas health officials acknowledge past problems with foster children being overmedicated. A scathing 2004 report by the state comptroller found hundreds of foster kids as young as 3 were being given psychiatric drugs; one older child had 14 prescriptions for 11 different medications, at a monthly cost of more than $1,000.

But state health officials say that since 2005, they've made significant strides, reducing the share of kids taking psychiatric medicine from 38 percent to 32 percent. They've also whittled the number of 3-year-olds on mind-altering drugs by more than 25 percent and reduced the number of juveniles on five or more drugs by 20 percent, according to state data.  

Prescriptions still common  

Experts say the raw numbers are still high. In fiscal year 2007, nearly 15,000 of the 40,000 Texas children in state custody were prescribed at least one behavioral drug, costing the state $37.9 million.

It's hard to tell how this compares with the broader population; there are few national studies documenting the number of children on psychiatric drugs. In a 2006 analysis of more than 2 million patients served by Medco Health Solutions, a pharmacy benefit manager, 4.3 percent of children under 19 were on an ADHD drug, and 2.4 percent were on an antidepressant. Less than 1 percent were taking antipsychotic drugs, which are considered the most powerful.

Of the top five drugs most often prescribed to Texas foster children in 2007, two psychotropic drugs – Risperdal and Seroquel – were not approved for use in juveniles. Risperdal, an antipsychotic, has since been approved.

Many adult drugs are commonly prescribed to juveniles without federal approval, and not just foster kids. But some that have been proved perfectly safe in adults have had dangerous effects on children, including hallucinations and suicidal tendencies that have led to so-called black box warnings on drug labels.

And even drugs approved for use in children, while effective in treating mental illness, can have serious side effects, including twitching and tremors, muscle stiffness, severe exhaustion and excessive weight gain. Some studies have found that placebos are as effective as certain psychiatric drugs at treating juvenile depression, raising questions about the usefulness of the drugs in the first place.

Despite doctors' relationships with drug companies, there's no evidence that clinical trials have ever been run on foster children in Texas. The most prominent case of experimentation on foster children occurred in New York City in the late 1980s and early 1990s, when the city's child welfare administration enrolled hundreds of kids in AIDS drug trials.

The trials, which proved highly successful and dramatically reduced pediatric AIDS deaths, still sparked outrage years later over allegations that the children were enrolled without proper consent.

"It makes me wonder what real safeguards there are here to protect foster children in Texas from being involved in clinical trials," Jack Downey, president and CEO of the Children's Shelter of San Antonio, said of the Texas doctors' drug company relationships. "Whether any wrong is being done or not, there's certainly the perception" that doctors are benefiting from the foster care prescriptions.  

Ties to companies  

The News' review of the top-prescribing psychiatrists and clinics turned up many with financial relationships with pharmaceutical companies. Among these connections:

• An El Paso psychiatrist who prescribed psychiatric drugs to nearly 300 foster kids between 2002 and 2005 won nearly $150,000 in research funding from Pfizer and Eli Lilly, according to the Web site of the university he is affiliated with. He was also a guest lecturer for an AstraZeneca-sponsored conference at a California beach resort, according to the conference's brochure. He did not return repeated phone calls to his office.

• A Houston psychiatrist who prescribed psychiatric drugs to 490 foster children since 2002 has helped run ADHD, depression and schizophrenia clinical trials. His research facility has received funding from Eli Lilly, Glaxo SmithKline and Janssen, according to the facility's Web site. He did not return phone calls, and his assistant said he no longer works with foster children.

• A Houston doctor has given talks at Eli Lilly-funded events, held teleconferences for Eli Lilly sales representatives, and has pitched one of the company's drugs in speeches, according to her practice Web site. She has prescribed drugs to nearly 150 foster children. She did not return phone calls seeking comment.

Psychiatrists who work with foster children and for drug companies say one doesn't influence the other. Dr. Giancarlo Ferruzzi, a San Antonio psychiatrist who treats foster children and has consulted for at least five pharmaceutical firms, said professional relationships with drug companies have no effect on his prescribing patterns. And, he said, he frequently relies on drugs from companies he's never worked for; anything else "would be a dereliction of duty."

As a psychiatrist who treats children in foster care and also conducts clinical trials for new drugs, Dr. Carlos Guerra of Houston works with lots of pharmaceutical companies.

"But I don't sit there and think, 'Hey, a Concerta rep came in today,' " he said. "There is more data out for the newer drugs, which makes doctors more likely to use them. That's why it appears there's something unethical going on with the drug companies when there's not."  

Fighting for her son  

Mary Kitchens was in the next room when her autistic 8-year-old dropped a lighted candle onto her bed and was unable to communicate what he'd done. After the house burned and Ms. Kitchens depleted her other children's college funds to put Evan in a private psychiatric hospital, the state took custody of her son, telling Ms. Kitchens the second-grader was a danger to his family.

The piles of leftover drugs in Ms. Kitchens' carefully appointed Bandera home tell the rest of the story. Seroquel. Lithium. Depakote. Losartan. Trileptal. Risperdal. Concerta.

"You name it," Ms. Kitchens said wearily, her voice breaking with each drug's name. "He was given three times the amount given to adult patients. Each of these drugs was given to us by a child psychiatrist."

In foster care in a residential treatment center, Evan, who was not treated by doctors discussed in this report, grew progressively worse. He ballooned from a size 8 to a size 14 – a side effect of many psychiatric drugs. His eyes crossed, and he convulsed with tremors. He had nightmares and panic attacks and hallucinated that bats were chasing him.

Ms. Kitchens, horrified that she'd ever agreed to turn over her son, took out a loan and hired an experienced attorney. On her 40th birthday, she brought Evan home, carefully weaning him off all but one of the medications. Evan's behavior is far from perfect, Ms. Kitchens says, but he's safe and he's happy.

"He was supposed to be in state care, but nobody was looking after Evan but me," said Ms. Kitchens, watching the boy, now 12, wriggling on the kitchen floor with Puppy, his dachshund. "Now my kids don't take medications. I won't ever trust doctors again."  

Are drugs needed?  

Brett Ferguson, a Kerrville attorney who has represented the interests of foster children, said many in-custody diagnoses seem unwarranted. Almost every child he has represented has been placed on a psychiatric drug while in state care, Mr. Ferguson said, even for minor behavioral problems. Some were so drowsy with medication that they could hardly communicate, he said, and caseworkers refused his requests to reduce their dosages.

"The state takes a child that is upset, crying, yelling and screaming because they've just been taken from their families and, with all those symptoms, prescribes them medication," Mr. Ferguson said. "They think that if the child is unruly, it's easier to deal with them by medicating them than by counseling."

One former operator of a foster treatment center, who spoke only on condition of anonymity for fear of damaging his business relationship with the state, said that half of the children at his facility "could've done with less" psychiatric medication or none at all – and that many were already "zombies" by the time they arrived.

"It's a medical model. We didn't have any other options," said the operator, who acknowledged that sometimes doctors didn't even spend 10 minutes with a child before prescribing a drug. "I always questioned, 'If they didn't need them out there in the real world, why do they need them in here?' But I wasn't about to go against the doctor's orders."

Curbing this kind of overmedication has been a priority, said Darrell Azar, communications manager for the Texas Department of Family and Protective Services. So far in 2008, nearly 22 percent of all Texas foster children have been prescribed psychiatric drugs for more than 60 days, down from 26 percent in 2005.

The percentage is expected to keep dropping – the result of the new health management program and a review this fall of the state's drug procedures for children in foster care.

"We're a lot more confident today that children who don't need these medications aren't getting them," Mr. Azar said.

http://www.dallasnews.com/sharedcontent/dws/news/texassouthwest/stories/DN-fosterdrugs_17tex.ART.State.Edition2.4d88f86.html

 

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More on clinical trials

Gwen Olsen, a drug industry watchdog, says drug companies are often holding the strings. She said she spent 15 years as a pharmaceutical sales rep trying to influence psychiatrists by minimizing drug side effects, sidestepping safety questions, and using marketing materials doctored to water down negative studies.

One of Gwen Olsen's videos can be found here:  http://poundpuplegacy.org/node/15759#comment-3722

 

Patient screening

I found a disturbing program called Teenscreen, which advertises itself as a service that offers voluntary mental health check-ups to families in their communities.   [According to the Columbia University webpage, Teensceen "celebrates" the opening of 500 sites.]

Meanwhile, on another site, [psychsearch.net] more information is given about this diagnostic psychiatric service.  According to the page found,  Marcia Angell, (medical ethics lecturer at Harvard Medical School and author of "The Truth About Drug Companies.") admits programs like Teenscreen boost the sale of antidepressants even after the FDA in September (2004) ordered a "black box" label warning that the pills might spur suicidal thoughts or actions in minors.

The following is a breakdown on how Teenscreen finds more people to be placed on prescription drugs.

Step One

TeenScreen lures kids as young as 9 years old into doing the suicide survey by offering them free movie passes, food coupons, "I completed TeenScreen" stress balls, pizza parties and candy bars - if they consent to the procedure.

One tactic TeenScreen officials use is to sell the child on the suicide survey first and after they have the child's agreement, they later contact parents.

TeenScreen Project Coordinator, Kathleen Cigich, was quoted as saying: "We found early on, though, that sending out letters directly to parents is prohibitively time consuming and gets a low response rate. We thought, why not go to students themselves and offer a $5 video store coupon to anyone who brings back a parental consent form within a two-day turnaround period. It works. Our response rate is extremely high."

TeenScreen also utilizes a "passive consent" form which requires no written parental approval. The passive consent form is sent home to parents and if they don't return it TeenScreen considers that the parents approve. TeenScreen officials favor passive consent because they say it boosts their chances of screening kids to 95% as opposed to the written parental consent technique. What if the child forgets to bring the consent form home? What happens if the parent is too busy to refuse in writing? They've consented in the eyes of TeenScreen personnel.

Step Two

The youngster is sat down and asked introverting questions such as:

Has there been a time when nothing was fun for you and you just weren't interested in anything?
Has there been a time when you felt you couldn't do anything well or that you weren't as good-looking or as smart as other people?
How often did your parents get annoyed or upset with you because of the way you were feeling or acting?
Have you often felt very nervous when you've had to do things in front of people?
Have you often worried a lot before you were going to play a sport or game or do some other activity?
Have you tried to kill yourself in the last year?
Are you still thinking of killing yourself?
Have you thought seriously about killing yourself?
Have you often thought about killing yourself??
Have you ever tried to kill yourself?

Step Three

Based on the answers the child gives to the above questions he is then shuffled off to a "clinician", who ponders the bogus label to use.

Social Phobia?

Panic Disorder?

Anxiety?

Obsessive Compulsive Disorder?

Active Suicide Ideation?

Passive Suicide Ideation?

You can find the checklist used to label the child here: labeling checklist

IMPORTANT NOTE TO PARENTS:

Parents are being mislead by a multi billion-dollar a year child drugging industry that a diagnoses of "mental disorder" (ADHD, Bi-Polar, Social Anxiety Disorder) are medical diseases or illnesses. This is a fraud. No child has a brain scan, blood test, X-Ray or any evidence of physical abnormality to verify they are "ill" or "diseased."

Yet psychiatrists continue to pound the public with misleading and fraudulent statements that these so called mental disorders are biochemical or neurological conditions. That is false. They are simply a list of behaviors that psychiatrists vote into existence and insert into their billing bible, the Diagnostic and Statistical Manual of Mental Disorders.

This has led to over 8 million children in the U.S. taking mind-altering psychiatric drugs.

The Diagnostic and Statistical Manual for Mental Disorders, 4th Edition (DSM-IV), published by the American Psychiatric Association (APA), is psychiatry's billing bible of "disorders" from which psychiatric screening, diagnoses and their treatment are derived. The current edition lists 374 psychiatric conditions that have been identified as mental disorders.

Yet, the disorders contained in the DSM-IV are arrived at by consensus, not by scientific criteria. There are no blood tests, brain scans, X-Rays, MRIs or "chemical imbalance" tests that can scientifically validate any mental "disorder" as a disease or illness. Canadian psychologist Tana Dineen reports, "Unlike medical diagnoses that convey a probable cause, appropriate treatment and likely prognosis, the disorders listed in DSM-IV are terms arrived at through peer consensus"- literally, a vote by APA committee members.

Step Four

The "clinician" summarizes his report and comes up with an "impairment score".

Step Five

Based on how the child answered the "suicide survey", and which label the clinician conjured up and how the child did on his "impairment score" the child is then sent off for "treatment".

What treatment?
Drugs. A survey of recently trained child psychiatrists found the treatment for 9 out of 10 children consisted of drugging. (Journal of the American Academy of Child Adolescent Psychiatry 2002)

The "treatment" used on children with these bogus labels can be found here: Medication Guidelines

"Treatment" is the long term goal for TeenScreen according to their director, Laurie Flynn.

What does the Food and Drug Administration say about these drugs? See here: Black Box Warning

http://www.psychsearch.net/teenscreen.html

Note what has been written about Laurie Flynn:  www.dissidentvoice.org/June05/Pringle0607.htm

Making it personal, for other parents

I learned in 2007, just how easy it is to have The State called to investigate a child's behavior and have it classified as mal-adaptive and dangerous.

Step Two describes exactly what happened to my nine year old son when he was in the fourth grade and questioned by his school's Guidance Counselor.  Our story on how a child can easily get labeled "suicidal" is here: http://poundpuplegacy.org/node/8649.

 

This hits home...

I am so angry with what happened to you and your son!  The school is SO easily swayed that there is "something wrong..." when there is only a mild something that could be dealt with IN THE HOME!  Whatever they saw in your son was SO blown out of proportion by these eagle-eyed MANDATORY home wreckers!!!  DAMN that law that makes almost everyone a reporter of child abuse!  There is abuse, and it must be dealt with IN A SANE WAY that is the least disruptive to the child/family/home!  I've seen some real cases of abuse where the kids were placed in foster care for a few years and then given right back.  WTF???  Keep them home; do in-home services; ANYTHING but the FORCED trauma most foster kids experience when stolen and fostered out to GOD only knows what kind of foster home.  There ARE good foster homes.  I just shudder at the many abusive foster homes that exist along-side of the good ones, taking the credit just because they have the name: foster home
I could spit nails!

What did I ever do to deserve this... Teddy

pill popping nation

The pharmacutical Giants are among the biggest lobbiests in Congress. Profits off the backs of the hurt, misunderstood, and poor and uneducated is the name of the game. I have read in the newspapers b4 that they want any child who doesn't conform/or is different to be put on drugs. Threatening the parents with jail even, if they don't comply. Our system is broken, and we are helpless to fix it. There's no profit in doing what could be right, there is profit in peoples misery. I have to say the same system used to abuse children is used to abuse adults too. I have been forced to take meds in these public mental hopspitals in order to be considered 'well enough to leave' never mind the monster I was living with at home. No 1 would even listen. It was here take this- or your being combative and in such a state your not ready to be released. What a fucked up system it is indeed. I suffered weight gains of 1.5 lbs a day to appease a Drs need of control. All this while my ex hub played the victim. Talk about sick....

given too much...

I had a total break-down 6 years ago.  Three years ago, it went even further down the toilet.  I was put on a high dosage of Effexor: 225 mg daily.  The doctor changed jobs and no one bothered to follow my progress (digression into the pits of the deep, dark abyss where I stayed).  I finally got myself off the medicine and opened my eyes to a different world.  I had not FELT one emotion other than pain for so long.  I will NEVER take another thing that will alter who I really am!  NEVER!  I am so scared of medicine after seeing how doctors THINK and what they DO! 
I gained 60 pounds on Effexor.  I didn't even taste any of the food I was eating; couldn't taste or feel: numb zombie.  It was hell on earth.  And I was forced to continue the meds because it was court ordered; never mind the real reason for my depression and PTSD!    So I DO understand what you are saying!
NG stated:   " There's no profit in doing what could be right, there is profit in peoples misery...." 
This is a sick and uncaring world we live in; a world that strives for more control as it sees itself losing just that: we were the POWERFUL USof A... and now, the world hates us.  SOOOO, the battle for control shifts to within.  The power-egos have to be fed.  Being a foster-parent for almost 5 years let me see, first hand, the deceit and cunning that went on to steal and keep other people's children.  The lies and coersion were shameful.  And they don't lie about it... they tell foster parents this:  hang in there, we are not going to let those kids go back to their families; you could end up adopting them.  I didn't want to adopt them; wanted to see them go back and start over with the help of the "system."  So that's why I went overseas to adopt; only to find that, without training, I was still not prepared to raise another's child as my own.  We are a selfish breed: AP's...  but it could be different if only the PTB would be honest with us and work for what is REALLY best for the children.  They tell us what we want to hear:  it will be PERFECT!  Just think, your very own children!  They are so dillusional.

What did I ever do to deserve this... Teddy

weighing in on the subject

There's no profit in doing what could be right, there is profit in peoples misery.

You really hit the nail on the head with that one. Benjamin Franklin already said: An ounce of prevention is worth a pound of cure. In his frugal mindset I assume he preferred the ounce of prevention to the pound of cure. In a modern day mindset, where only profit counts, the expression takes an entirely different meaning: why sell an ounce of prevention, when you can sell a pound of cure?

In the context of health care, it is obvious that pharmaceutical companies rather see people get sick, so they require medication, than see people try to prevent from becoming sick in the first place. There is of course some money to be made through prevention, but by far not as much as through popping pills, so the pharmaceutical companies have much more lobbying power than those organizations involved in preventive health care.

The same is true for many other subjects. Closer to the issues PPL is focusing on: teen pregnancies, still a source for unnecessary adoptions. Prevention is cheap. Proper sex-education and accessibility to anti-conception could probably reduce the number of teen pregnancies by several factors. Yet there is a large section of the pro-life movement adamantly against all sorts of preventative measures, except for abstinence (which doesn't work). The pro-life movement finds strong endorsement from such organizations as Heartbeat International, which is backed by several of the large Christian adoption agencies. Again there is more to be earned with a pound of cure than with an ounce of prevention.

Another issue close to PPL's heart is the removal of children by Child Protective Services, again, there are intensive family preservation programs that have a good track record and deliver those results for a fraction of the cost involved in foster care. Still those programs usually face budget cuts to fund expensive forms of child placement, such as residential care. Large sums of money can be made through residential care. Organizations receive a per diem for each child they take in and as long as the cost can be kept lower than that per diem, every day that child is in care is another day profit is being made.

Of course society at large loses. The cost of health care has sky-rocketed over the years, the teen pregnancy rate in the US is 8 times higher than in several European countries and the foster care system has been broken since the day of its invention. The societal costs are enormous, but so are the individual gains of those involved in these industries, and those gains buy access to policy makers. The societal influence on politics is bi-annually, when elections are being held. Special interest's influence on politics is daily.

my son from Missouri

they had a nurse make all the appointments, etc... for the child it sounds much what Texas was talking about.... trust me this also helped very little... i was just another person getting paid to do nothing... :(

A Different Situation...

When my oldest child was born almost 9 years ago, it quickly became apparent that he was different....

He rarely slept, even as a newborn. He was so physically active he FORCED himself to walk at 8 months of age, and also developed a bizarre seizure disorder (the specialist had never even seen it...they were of a tonic nature) around the same age.

By one he was having full blown tantrums, slept 5 hours a night, weird freak outs, you name it. When his seizures suddenly stopped when he was 2 1/2, we really did think all the other behaviors would go away. It got worse each year instead. We tried every diet, behavior mod, etc.....nothing.

I am quite lucky in that my son's CRNP is wonderful and has been with him since he was born. She helped with all of our decisions and stood by us. When it became obvious that he was not doing well at all in kindergarten (his teacher went as far as to claim that he was retarded and needed to be in special ed.), his CRNP recommended that we enroll our son in a program with the child psych. dept. at a large local hospital. Twice a week for six weeks for two hours, the parents attended a meeting while the children were put in 'play' groups (they were actually being studied) and monitored.

The meetings helped me immensely. I did not feel so isolated with a 'problem' child. The child psychologist was great and gave all of us a lot of workable solutions and suggestions. At the end of the six weeks, my son was given an additional pysch. battery and an I.Q. test. The diagnosis was ADHD.

With some releuctance, I agreed to allow him on a 10 milligram dose daily of ritialin. Four years later, I'm glad I did. It hasn't changed his personality or made him a zombie. The difference is you can have a converstaion with him and he can follow directions, he doesn't get caught in terrible frustration that he can't get out of. He's doing great in school and is popular with the neighborhood kids.

As a few of you know, I'm an artist and he's showing talent much more advanced then I was at that age. He had work of his in a charity calendar last year and also took two ribbons in a district wide contest. He couldn't even sit still long enough before to color in a coloring book .

When I contacted my bio-fam last summer looking for medical information, it did come to light that my half brother, Jim, has had ADHD his whole life also. He takes ritialin everyday, and for him it's rather vital....considering he's the engineer on a passenger train line.

On another note...my son's earlier tonic seizures are also a family trait. I had been having non-epileptic seizures for years and didn't quite know what was going on, even when they escalated to full blown trigeminal neuralgia. I've since gone on tegretol and feel considerably better.

A major difference

Personally, I believe there is a huge difference between ridding bothersome behaviors and carefully investigating/treating a serious problem.

This past year, I had to take my oldest daughter to the hospital for a 72 hour EEG testing procedure.  Based on her symptoms, it seemed as though she was developing a seizure disorder.  [I can't help but think when an adoptee has a child with "different problems", the first thought goes something like this:  "OK...WHO in my f-n family had this (and why didn't anyone prepare me)?!?"] 

My nature is to question EVERYTHING because I don't believe people are always telling me the whole truth.  As a result, when someone tells me something to believe, I often say, "Show me, on paper..in a book...I want you to give me trustworthy, reliable proof."  [The adoption-joke being, just because something is written by somebody, that doesn't mean that's the absolute gospel truth.]

My daughter's suspected seizure disorder turned out to be nothing of the sort.  Her symptoms were caused by something I used to experience as a child:  POTS.  Postural orthostatic tachycardia syndrome.   The cure so far has been simple:  increase salt and fluid intake to help maintain a healthy fluid balance.  Only when the dr went through the list of symptoms and causes did I remember how often I used to pass out and get dizzy when I was little... and how little I would drink. 

I imagine if I took her to a lazy crack-pot doctor.  One who didn't take the time to carefully test and study the patient before prescribing medications known to reduce or eliminate certain bothersome symptoms/problems.  I am thankful we have good medical insurance and live in an area where health-care is quite good.

Bottom line for me.... health-care put in the wrong hands can not only be dangerous... it can be deadly. 

Mdicating ADHD

Your story of ADHD is a good point.You took an active role in figuring out just what was the matter. Against your own misgivings you gave your child a needed med, and your reaping the benefit from it. I will point out, your son is actually reaping more benefits-because he can now function in a civilized way, and develop the much needed self-esteme he needs being different. Most parents who object to medicated ADHD end up with a emotionally disturbed person, and alot of bad feelings on both the  parent/childs part, never knowing/accepting it could be simply fixed like a light switch, with the use of 1 type of med. I've observed it many times- the destructive behaviors that a child goes through trying to control himself, blaming themselves for something they have no control over, ending up as drug addicted self medicators-never quite knowing what/where/why went wrong.  

I too was treated with Ritalin as a child after diagnosisof ADHD. Then they told (my) parents that you outgrow it. I have subsequintly have found out that NO you don't ever outgrow it. While struggling with my ex- like I said in  previous posts, the PTB wrote down many different psudo-diagnosises off handedly based on my particular set of symtoms they viewed at the time-, and thus now I have a medical chart with God only knows the crap that I've been mislabelled with. Those GD-SOBs have ruined me on paper. I'm proud of you for taking the needed steps and doing what is right for him. Just remember, they never outgrow it, it is a chemical imbalance. I am praying to find a Dr. that will look past all the mislabels and represcribe me the 1 thing I do need to function at my optimum, a stimulant. That is where my real issue is, not in any sort of mental illness, My ex took that with him when he left. I just paid the price.

My Son

I honestly don't believe my son will ever outgrow ADHD. My half-brother seems to be living proof of that.

What I wish is that all children would ned, NEED to complete some sort of medical program before they are placed on ritialin...to rule out parents who just wish their child would shut up and sit down.

I also don't look at my child's condition as a behavorial issue, I look at it as a medical issue. I have gone to great pains to co-ordinate his care, from the child psych. team, to the school nurse, to the CRNP, etc.

I also made sure that at the time the meds started to have the CRNP check him every three months to make sure he was ONLY on enough medication to manage his symptoms, and not have him 'snowed under'.......On an interesting note, his witch of a kindergarten teacher actually said' "If he's going on medication, he should be on enough that he doesn't even MOVE anymore.". I reported this to my son's CRNP immediately, she turned as red as a beet and called the school board while I was in the office.

Seems Ms. Teacher got in a bit of trouble after that.

what happens most of the time in the real world

..... My son's Missouri medical case manager.... she was about as good, maybe a tad better than the RTC he was in in keeping up with paper work... meaning she just didn't

she didn't advocate a thing... made sure min. trips to Dr. were made

what happens to most foster kids around here in Virginia

child enters care; child over 3 must in almost all case been seen for mental health eval., and placed in therapy.... therapy group and rules about Medicaid want all children in therapy on meds to decrease need of therapy... kid is screened by psy. dr. or primary care doctor... not indepth study, usually 5 min. visit... and handed (in all but 2 cases I know about) a pill bottle....

my son had up to 7 foster kids living in his foster home... all kids visited same psy dr. all kids were on the same 4-5 meds.... the kids came from 5 different bio families.... for just one example

my daughter, still foster at the time, had not behavior problems or concerns at my home, at school, etc... she was screend at the end of her foster placement for transition to adoption... and some nut job mental health person decided she needed to be on anti-depressants... and we had to go get the drugs filled and say we were giving them to her until the adoption was final some 14 months later (the system sucks) the 6 year old was not depressed...

and you want socialized medician

about sex ed in the USA.... actually very few kids are getting knocked up now a days... most sexually active well off teens will happily go to the abortion place and end the life of the baby the created by their own choice.... birthcontrol has its problems none of which are risk free or 100% effective... you can educate the snot out of them and it will not do any good... (sure birth control is not as free in some places, but say when we lived in West Virginia anybody could walk into the clinic with a short wait and get their pills, shot, or condoms) not true in Virginia..... there is still a growing problem in the USA, or a least a real problem in the USA amoung some social economic groups where they have a baby to get a check...
there is no shame any more for being a single parent....
there is a real problem with the way sexuality is presented in the media.... I don't know... I only know of one college roommate who literally screwed about 40 men one semester of college... maybe most people are out there doing that... but I think most don't....

heck you can't even really send kids to school around here without knowing they will get sexually assualted at school.... girls often have their chests touched by boys just walking down the hall, out right nasty crap is talked about all day long..... I've known of more than a few girls who have been forced to give hand jobs to boys in the lunch room and little is done to the boy.... gosh just yesterday had conversation with a 12 year old child of mine about the difference between a head job and a blow job because such and such as said she given her boyfriend a head job.... 12 years old... 6th grade....

is it really that bad to be telling these 12-16 and even older kids to keep their legs together and keep it in their pants until they are older? and let us not even get into the very real concerns about STDs.... I still tell my children the best thing your going to catch screwing around is a baby.....

and I guess it comes down to... so you'd rather be dead than not adopted....

but getting back to the drug issue.... the fact is that big pharma makes billions off this... they don't care who gets hurt... my son has been on as much as $2,000 per month medication for behavior issues that go away if the school puts him in good programs... so it can't even be about the money

there are real issues about how the government will let people parent; why place child in care if they are returning home because it does so much harm to them.... ; and some many more issues...

but all most kids and adults for the matter get is here is a bottle we don't care, go away

my son was placed on seroquel at his RTC.... he slept all day, got cranky a bit a night then the next dose hit... what a way to live.... and from the research I have been able to do they are not even shy about the fact that near 100% of the people who use the drug end up with diabetes and liver function issues 6 months to 5 years of usage.... :( it almost seems like they are trying to kill all of them to me

Drug-firm interests, revisited

Drug-giant Pfizer pleads guilty to illegal marketing, and is fined $2.3 billion.  More note-worthy is the following information:

Pfizer was deemed a repeat offender in pitching drugs to patients and doctors for conditions not approved by healthcare regulators.

Pfizer had pleaded guilty in 2004 to an earlier criminal charge of improper sales tactics and its marketing practices have been under federal supervision since then.

The company, which is acquiring rival Wyeth (WYE), had warned in January that it had taken a $2.3 billion charge late last year to resolve allegations involving Bextra and other drugs. However, it didn't provide details.

Pfizer pulled from the market in 2005 after the Food and Drug Administration said the drug could cause a dangerous skin condition and as well as cause heart problems. At the time, Bextra was generating $1.3 billion a year in sales

The settlement announced on Wednesday by Pfizer includes a $1.3 billion criminal fine related to methods of selling Bextra.

It also includes $1 billion in civil payments related to so-called "off-label" sales of drugs -- meaning for uses not authorized by the FDA -- and payments to healthcare professionals.

Marketing fraud cases against pharmaceutical companies have become almost routine, The New York Times said, with almost every major drug maker being accused of giving kickbacks to doctors or shortchanging the Medicaid program on prices.

Prosecutors said that they have become so alarmed by the growing criminality in the industry that they have begun increasing fines into the billions of dollars and will soon start charging doctors individually as well.

In January, prosecutors announced that they would fine Eli Lilly (LLY) $1.4 billion for its illegal marketing efforts on behalf of Zyprexa, an antipsychotic.

Drug companies often pay physicians to prescribe their drugs to patients.

In fact, The Times reported today that marketing plans developed by Forest Laboratories (FRX) for its drug Lexapro included using cash and other perks to persuade psychiatrists, primary care doctors and other medical specialists to prescribe the antidepressant.  [From:  Pfizer fined $2.3 billion in drug-marketing case, Charley Blaine ,Sept 2, 2009 ] 

damn them all!!!!!!!!!!!!!

The Department of in-Human Services were behind my daughter seeing three psychs a month and DRUGGING her with sometimes three drugs, including LEXAPRO which we just got her off of since she came home!
I pray these companies will be damned to HELL for what they are doing to children in foster care!
My daughter just told me Zyprexa was another one she was on!  GRRR>>>>>>>>>>>>

What did I ever do to deserve this... Teddy

off subject but the same difference

Another point-

This also goes to say how many judges are in the business of prison populations.

They own the prisons, so they just sentence the cases accordingly.

It is a scary world out there- and there's no REAL legal services if you don't have a DEEP POCKET.

Talk about a Prison Planet/Drug Nation.

-it's insidious......

still off topic

Your comment made me think of this case.

Pound Pup Legacy