Calif. group homes drugging children to keep them docile 'We sometimes don't know who put kids on drugs'

Children under state protection in California group and foster homes are being drugged with potent, dangerous psychiatric medications, at times just to keep them obedient and docile for their overburdened caretakers.

A review of hundreds of confidential court files and prescription records, observations at group homes and interviews with judges, attorneys, child welfare workers and doctors across the state revealed that youngsters are being drugged in combinations and dosages that experts in psychiatric medication say are risky -- and can cause irreversible harm.


In part because of a lack of oversight, officials responsible for the children's welfare say they don't know how many of California's 100,000 foster children are being given mood-altering medications, many of which have never been tested for use on children.

In Los Angeles County, which has nearly half the state's foster children, dependency court judges approved requests last year to medicate about 4,500 children. That doesn't include those drugged with parental consent or those drugged with no consent at all, which experts believe is a significant problem.


In addition, a county grand jury found in 1997 that nearly half the group home children it examined were drugged without court or parental consent.

Experts from around the state said widespread drugging, both with and without legal approval, occurs in other California counties as well.

"We sometimes don't know who put kids on drugs and why," said Nathan Nishimoto, an Orange County Department of Children and Family Services official who, until recently, was in charge of tracking children in the county's care.

Many psychiatrists vigorously defend the use of psychotropic medications on children in foster homes and group homes, arguing that the benefits of using them on these often troubled youths outweigh risks of harm.

"Your hand gets forced when these children are so disruptive," said Stephen M. Stahl, who teaches psychopharmacology at the University of California, San Diego. "How sick would they be if you didn't give them drugs?"

Dr. James Hogrebe, who works with grade-school-age children at an Anaheim group home, said, "Most [of these medications] can be used safely, if they're monitored correctly."

But the lack of proper monitoring is precisely part of the problem, say numerous officials involved in the child welfare system.

In many instances, the doctors who prescribe what their colleagues call "chemical straitjackets" aren't psychiatrists and have little training in the highly specialized field of psychiatric medications.


According to group home directors and child care workers, some of these doctors and psychiatrists examine a child for minutes

before prescribing powerful, behavior-altering medications. And some come after dark, when children are asleep, look at files and write prescriptions.

These revelations come at a time when many experts have expressed serious reservations about the rising number of children in the general population who are being prescribed adult medications.

An estimated 800,000 children and adolescents nationwide were prescribed antidepressants such as Prozac, Paxil and Zoloft last year, according to IMS America, an industry research company that surveys physicians. Another half-million children, ages 6 to 12, were prescribed Tegretol and Depakote, two adult antimanic, antiseizure drugs, the company's data show. And in 1996 some 3.25 million children in that age group were prescribed drugs such as Ritalin to control hyperactivity, IMS America says.

Joe Huley, in charge of group home inspections for the Orange County Department of Children and Family Services, ordered one Tustin group home for children ages 3 to 12 to fire its psychiatrist in 1996 after discovering that the doctor was prescribing the tranquilizer Thorazine for every child in the home -- whether it was needed or not.

While many of the children do need treatment, many others in the state's care are drugged for expressing normal angry reactions to abuse and abandonment -- or for just being rambunctious children, say children's attorneys and some psychiatrists.


Pub Date: 5/17/98