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The Press Democrat
At 13, De La Torre was taken from a broken home by the Sonoma County welfare system. Soon after that she was prescribed Zoloft and Prozac to help her deal with her depression, anger and sorrow. Instead, she said she used those psychotropic pills to try to kill herself.
De La Torre, now a student at Santa Rosa Junior College with an eye on a career in naturopathic medicine, continued to take psychotropic medications after entering the local foster care system. She said she laments never being given an alternative to the drugs, which she said did nothing to make her feel better.
“If anything, it made me feel like suicide was a better option,” she said.
De La Torre said she believes she was inappropriately prescribed psychotropic medications as a means of controlling behavioral and emotional issues that should have been dealt with in other ways.
Such alarming rates have drawn the attention of investigators for the California Medical Board, who are trying to determine if physicians may be inappropriately prescribing the medications. The board’s review comes as county social welfare departments across the state are also trying to grapple with any potential problems.
Sonoma County is at the top of the list of counties with the highest rates of psychotropic prescriptions among foster youth. Nearly 23 percent of all local foster kids were on the drugs during the 12-month period that ended last June, nearly double the 11.8 percent rate for all 79,166 children who were in the state’s foster care system.
“You have to ask: What are doctors in Sonoma County learning about how to prescribe?” said Carmen Balber, executive director for Consumer Watchdog, a consumer advocacy group that in recent years has called for tougher monitoring of medication practices in the foster care system.
Some children in the foster system warrant a psychotropic prescription, Balber said. But the current levels are “disturbing,” she said, particularly since the young people involved have fewer advocates than most other kids.
“The big concern is that these medications are being used to control behavior instead of legitimate mental illness,” Balber said. “It is impossible that one quarter of kids in the foster system have such severe mental illness to justify these medications.”
Last year, Gov. Jerry Brown signed a set of bills aimed at curbing the overuse of psychotropic medications in the state’s foster care system. The bills increased the responsibility of the juvenile court system, the state Department of Social Services, public health nurses and others to monitor the use of psychotropic medications on an individual and statewide level. But foster youth advocates say the bills omitted one key player: doctors who prescribe the medications.
This year, state Sen. Mike McGuire, D-Healdsburg, has sponsored a bill that would authorize the California Medical Board to collect confidential information about psychotropic medications prescribed to foster youth. The legislation, SB 1174, which is scheduled to be considered by the Senate Appropriations Committee on Monday, would allow the medical board to investigate possible cases where a physician is overprescribing or inappropriately prescribing psychotropic drugs.
McGuire said the California foster care system is overusing psychotropic medications, which may prove harmful over time to the children placed under system care.
The drugs are necessary for some youths who have experienced “incredible trauma,” he said, but are in many cases being used to control their behavior and substituted for the therapy they need.
“We’re talking about people’s lives,” McGuire said. “California has known for a decade that psychotropic medications and antipsychotics have been overprescribed and we haven’t done a damn thing about it.”
Medical researchers have shown that prolonged use of antipsychotics can cause lifelong harm, contributing to obesity, diabetes, brain damage, organ failure or even death, McGuire noted.
Most of the physicians who care for foster children are doing an appropriate job, he said. His bill is aimed at “a small percentage of prescribers” who are engaging in potential violations of state law, he said.
Anna Johnson, policy analyst for the National Center for Youth Law, which helped craft both McGuire’s legislation and last year’s bills, said SB 1174 helps bridge the gap between county welfare and mental health departments. Too often, she said, county welfare systems contract with mental health department psychiatrists to do little more than prescribe psychotropic drugs.
“That’s problematic because these medications are not supposed to be the first and only treatment that a child receives,” Johnson said.
Johnson said psychotropic drugs, when prescribed inappropriately, such as in the wrong dose, can often blunt a child’s development. Some of the drugs block dopamine receptors that would allow a child to feel joy or form attachments.
“Some of the more positive sensations are dulled by the drug, or they might be inhibited in some way,” she said. “Some studies show that kids become like zombies. … They’re not able to react in the moment or be themselves.”
She said some young people, when prescribed doses that are too high, will lose trust in their caregivers or providers because of the extreme negative side effects, which include heart disease, diabetes, weight gain, ticks and tremors, an increase in suicidal thoughts and even sudden death in some youth, especially when these medications are mixed with other recreational drugs like alcohol or marijuana.
McGuire’s bill would provide additional information that the state medical board says it needs to complete its review of prescribing patterns statewide and identify the physicians who may warrant additional investigation. It includes the diagnosis associated with the medication, dosage and weight of the youth, said Cassandra Hockenson, a medical board spokeswoman.
“Keep in mind, this is necessary for us to determine who potentially is prescribing inappropriately,” she said.
Anthony Northern was about 14 years old when a conflict with his brother landed him in Juvenile Hall.
He was removed from his home and sent to a local group home, where he was put on several medications, including Seroquel, which is often used to treat schizophrenia, bipolar disorder and depression. Northern, now 21, said nearly every other youth in the home on medication for mental health issues was required to take Seroquel.