Tuesday, February 26, 2008

The drugging of America's kids

Every day, thousands of kids are getting pharmacologic treatment with psychotropic drugs they probably don't benefit from and that may well endanger them. New Jersey, like other states, has formed a task force to probe the use of antipychotics in children. Until very recently, these drugs were not evaluated with adequate and well controlled trials in children or approved for use in the pediatric population. To make matters worse, it appears as though children may have been prescribed these medications to treat indications that weren't even studied or approved for adults. It's most likely a majority of these kids may have been given these meds to treat ADHD and the prescriptions were not given by psychiatrists treating significant and/or moderate to severe mental health disorders. I am not a Xenu-phobe, I do not think that psychotropic drugs are evil or should be banned and I am fully aware that there are many people, including some children, that have significant and severe mental health disorders that warrant psychological and pharmacological intervention. I also know that there are some kids whose inability to concentrate/focus is so far from the norm of his/her age group that it is and should be treated as pathological in order to try to get the child back on track - but this is not true for all children diagnosed and treated with ADHD.

I've said it before, and I'll say it again: this is not a problem with psychiatry or even a problem with the Pharmaceutical Industry (though Pharma takes great advantage of it). This excess, injudicious use of medications is a problem with our society.

I don't know why pediatricians and GPs/FPs are willing to capitulate on prescribing these drugs to appease people instead of trying to determine which child really has a significant problem (and then probably turfing them for a psych/neuro consult) and which have the immature frontal lobes that leads to poor impulse control because, as children, their neurological development is ongoing.

Unfortunately, doctors don't seem to be willing to say no to patient/parent demand for a pill to cure our ills (real or imagined). Two things need to happen to rectify this situation:
  1. Physicians need to stop treating patients/parents as clients and start evaluating them clinically to treat them as patients
  2. We, as a society, accept that children are children and that means they will act like children (poor impulse control and all), we will continue drugging those who do not need and are unlikely to benefit from these medications.
Both of the above will have to occur to make any real change, our children and our society will be stuck between the extremes of those who do not want to acknowledge or treat any mental health disorders and those who are too willing to drug others to control them.

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