The poor ye drug


I wouldn’t say never.

If family therapy hasn’t helped the child settle down, if the psychotherapy for him or her hasn’t turned things around, if vigorous exercise hasn’t lifted the depression – then I might say go ahead and try an antipsychotic drug for the child.

But when you consider that over 300,000 kids in this country are on some kind of psychotropic medication, I suspect things have run amok.

I’m not alone.  Indeed, there’s a group of public health officials from 16 states who’ve formed a group looking at the problem.  They’ve named this effort, “Too Many, Too Much, Too Young.”

These officials are on to something.  For one thing, their worry is legitimate given results of the new study comparing the use of drugs for poor kids and those given to kids whose families have private insurance.

Here’s this storyl.  Researchers from Rutgers and Columbia found that poor kids are four times more likely to get the drugs than other kids.

What accounts for the disparity?   The researchers speculate that it comes down to money.   Private insurance reimburses more dollars for therapy and does Medicaid. That’s the health insurance most poor children are on.

There’s probably more to it than that.

Primary care doctors do most of the prescribing of psychotropic drugs.   Poor families are less likely to seek out therapists or psychiatrist than other families. And middle-class families likely are more apt to seek counseling or other services from mental health professionals.

For my part, I have several objections to drugging any kids with anti-psychotics willy-nilly.

The drugs have powerful side effects.  They  can cause weight gain.  Lots of it.  They can cause agitation – or lethargy.   If they help at all – often they don’t – many must be taken for a year or more to avoid relapse.   Recent evidence shows the drugs raise the risk of suicide in young people.

In addition,  the drugs often serve as a substitute for therapy and other activities than offer a more permanent answer.

Finally, when you hand a child or teen-ager a drug, you also hand them a diagnosis.   For many kids, that diagnosis becomes a label, even a lifelong label.   That person then naturally internalizes the label.  It’s his or her identity, a handicap than can limit one’s ambitions, talents and dreams.

“Depressed,” “bipolar,” “schizophrenic” becomes “I’m disabled,” “I’m not up to it,” “I won’t try,” “I can’t.”

That’s my quarrel with automatically  treating behavior and mood problems in kids with antipsychotics.

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