Doping Kids in Florida

Miami Herald
Creating juvenile zombies, Florida-style
May 28, 2011
By Fred Grimm

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.

====================
Palm Beach Post
End juvenile injustices
By Rhonda Swan
May 27, 2011

New Florida Department of Juvenile Justice Secretary Wansley Walters is right to examine the department's use of antipsychotic medications following a Palm Beach Post investigation showing that children in DJJ care are being plied with heavy doses of the powerful drugs.

"We will look at everything that surrounds this issue," Ms. Walters said in an interview. "We're concerned that any child in our care be given the best medical assistance possible, appropriate to his medical needs." DJJ's inspector general will conduct the investigation. Ms. Walters said one of her first acts was to ensure that the inspector general report to the state and not to her. Good move. "That way," she said, "they can't give me a report that I simply stick in a drawer."

As The Post's Michael LaForgia reported in stories last Sunday and Monday, psychiatrists hired by the DJJ prescribed antipsychotics before federal regulators approved them for children. The drugs can cause suicidal thoughts in children and other dangerous side effects. Gabriel Myers, a 7-year-old who was taking a combination antipsychotic and antidepressant, hanged himself two years ago in his Broward County foster home. The FBI's Behavioral Analysis Unit concluded that the drugs "may have contributed to his actions directly prior to and during his accidental death."

The Post found that the DJJ doesn't track prescriptions, and doesn't know whether doctors are medicating children because it's necessary or because it makes them easier to control. It's unclear whether the doses prescribed were appropriate or unusually high. The department should institute a tracking system, and the investigation should answer these questions.

The Post also found that some prescribing doctors have taken thousands of dollars in speaker fees and other gifts from drug makers. In two years, the four highest-paid psychiatrists received nearly $200,000. Three continue to treat children in state jails and residential programs. Studies have shown that even small gifts can influence a physician's prescribing practices. Pharmaceutical firms spend nearly $30 billion a year nationwide to market their drugs, most on dinners and trips for doctors, and samples for patients.

In 2008 and 2009, Florida doctors received $21.7 million from just the eight drug companies, including AstraZeneca, that disclose payments. More than 70 companies do not disclose. AstraZeneca makes Seroquel, one of the most popular drugs prescribed by DJJ psychiatrists. Florida doctors got more than $1.5 million from the drug maker in those two years.

State legislators, who wrongly prohibited pharmaceutical companies from donating money for the state's drug database, should prohibit them from attempting to bribe doctors - particularly those who work for the state - to prescribe their drugs. And on behalf of the children and their parents, Ms. Walters should make changes in drug policy her start on reforming an agency that has been mismanaged for most of its nearly two-decades-old existence.

"We assume that humanism will take the path of social and mental hygiene and discourage sentimental and unreal hopes and wishful thinking." -Humanist Manifesto I, 1933, Eleventh Point