Creating Juvenile Zombies, Florida-style

 They’re children of the new Florida ethic. Zombie kids warehoused on the cheap in the state’s juvenile lock-ups. Kept quiet, manageable and addled senseless by great dollops of anti-psychotic drugs.
A relatively small percentage of young inmates pumped full of pills actually suffer from the serious psychiatric disorders that the FDA allows to be treated by these powerful drugs. But adult doses of anti-psychotic drugs have a tranquilizing effect on teenage prisoners. Prescribing anti-psychotics for so many rowdy kids may be a reckless medical practice, but in an era of budget cuts and staffing shortages, it makes for smart economics.

Florida fairly inundates juvenile offenders with this stuff.
The Palm Beach Post reported last week that the Florida Department of Juvenile Justice has been buying twice as many doses of the powerful anti-psychotic Seroquel as it does ibuprofen. As if the state anticipated more outbreaks of schizophrenia than headaches or minor muscle pain.
The Post found that Florida purchased 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs during a two-year period for the boys and girls who occupy the 2,300 beds in state-run residential facilities. (Most of the state’s juvenile offenders are held in jails operated by for-profit contractors. Records revealing the quantity of medications that private companies pour down their prisoners’ gullets were not available.)

Such drugs, meant for adults, are known to send children into suicidal despair, along with risking heart problems, weight gain, diabetes and facial tics. Yet, the DJJ and its contract psychiatrists push them willynilly onto their young wards.
It’s not as if state officials have been unaware of the risks facing children prescribed “off label” uses (unapproved by the FDA) of these pharmaceuticals. Even as the state doled out Seroquel like candy to kids in DJJ jails, the Florida Attorney General’s office was entering into a lawsuit with 36 other states against drug manufacturer AstraZeneca for promoting dangerous, off-label uses of Seroquel for treating both the young and the elderly. (AstraZeneca agreed to settle the lawsuit in March for $68.5 million and to stop marketing the drug for unauthorized uses.)
It was as if the schizophrenics most in need of Seroquel were roaming the halls of government, not the juvenile jails.

“This is the face of all these budget cuts; what happens when you eliminate social workers and prison guards,” said Broward Public Defender Howard Finkelstein. He suspects that DJJ has compensated for the staff shortages at state lockups by pumping “the most powerful drugs known to man into children who have not been diagnosed for psychiatric problems.”
Finkelstein says he assigned two of his staff attorneys last week to visit juvenile lock-ups and investigate what he calls the “zombification” of young offenders who had been represented by his office.
Florida Attorney General Pam Bondi opened her own investigation last week. Bondi’s staff attorneys are interested in the Post’s report that psychiatrists prescribing off-label uses of such astounding quantities of the profitable anti-psychotics for DJJ prisoners (at taxpayer expense) had been greased by drug manufacturers with some $250,000 in gifts and speaking fees.

The DJJ drug scandal seems all the more maddening considering that it follows a similar uproar just two years ago after the suicide of a seven-year-old Margate foster child. Young Gabriel Myers had been given adult dosages of three anti-psychotics before he hung himself.
The Gabriel Myers Task Force, made up of child advocates, state officials, political leaders and judges from across the state, spent a year investigating whether the Florida Department of Children and Families had administered dangerous drugs as “chemical restraints” for troublesome foster children.
Foster kids, as it turned out, weren’t the only victims of the on-the-cheap ethic. But don’t think of children reduced to zombies. Think of all the money we save on prison guards.

Read more: http://www.miamiherald.com/2011/05/28/2240617/creating.html#ixzz1NkgowuEo

Foster Care Failures In Florida

Two disturbing facts about the Florida foster care system have emerged following the suicide of a 7-year-old boy on psychiatric drugs. First is the extraordinary prescription rate for children under the supervision of the Department of Children and Families. Second is the alarming revelation that a 2005 law aimed at tackling that problem has been repeatedly and systemically ignored. 

So far, DCF Secretary George Sheldon, eight months into the job, is to be commended for the openness and urgency he has brought to the agency's investigation. But his true challenge will be altering the culture of an agency that failed to implement the safeguards already in place. 

Agency critics have long argued that too many foster children are being medicated for the convenience of caregivers. As of Friday, an ongoing review of DCF's foster care database found that at least 400 more children are taking psychiatric drugs than initially thought. That means at least 3,068 — or 15 percent of the 20,000 foster children — are receiving the drugs, compared to 5 percent of the state's children. 

What's more, DCF acknowledges at least 14 percent of the children received the drugs without the informed consent of the parent or the court. Sheldon believes the percentage is higher, because he suspects many parents weren't adequately informed of potential side effects of such drugs or didn't speak to the physician. 

Sadly, the revelations come four years after concerns about pediatric use of antipsychotics and antidepressants — few of which have been tested or approved by the FDA for use by children — prompted legislative action. A 2005 law requires that all foster children's prescriptions be approved by a parent, or if parental rights have been terminated, by the court. The law also made clear that DCF was to monitor children on such drugs. 

In response, DCF included questions about medications and parental consent on its database software. Local providers use the program to create the official state record of each child. But time and again, Sheldon acknowledges, caseworkers have failed to fully complete the forms or lied about obtaining consent. 

DCF's failure to follow the law was laid bare by the tragic death of Gabriel Myers, a 4-foot-tall, 67-pound boy who hanged himself from an extendable shower hose at a South Florida foster home in April shortly after having his medication changed. He was taking Vyvanse, an ADHD drug, and Symbyax, a combination of the antipsychotic Zyprexa and the antidepressant Prozac. Symbyax carries a "black box" warning that it might lead to suicidal behavior among children and adolescents, especially when first prescribed. Neither his parent nor a judge had approved the prescriptions. And his death came after 10 days of tumult: His mother had lost visitation rights. He had been in two foster homes, changed therapists, and been told he would be going back to Ohio, where he had been sexually abused.
Since his death, caseworkers across the state have been ordered to go through their files and remedy shortcomings — from updating the state database to reaching out to parents whose consent was never sought for their child's medications. DCF has also convened a panel of experts aimed at addressing what else might be done. Among the likely outcomes, Sheldon said, are new protocols before a child is given powerful psychotropic drugs, such as requiring a review by a second doctor. 

Such changes will only work if Sheldon succeeds in changing a culture that ignored such safeguards. DCF relies heavily on nonprofit local providers to do its work. Those providers need to fully understand what is at stake, as do their employees. Four years after the Legislature thought it had addressed this problem, a 7-year-old's suicide is a stark reminder that the system is still terribly flawed. How long will it take to get it right?

[Last modified: Jun 06, 2009 11:34 PM]

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