Rutland Herald Dubie, Shumlin criticize psychotic drugs for kids

May 1, 2008
By DANIEL BARLOW

MONTPELIER — The top two leaders of the Vermont Senate joined a prominent mental health advocate Wednesday in decrying the growing trend of prescribing medication to children that has only been approved for adults.

Lt. Gov. Brian Dubie and Senate President Pro Tem Peter Shumlin said during a Statehouse press conference that Vermont needs to begin investigating how often these mind-altering drugs are given to children and why.

Shumlin said the state needs to get active in stopping the sole reliance on antipsychotic medications for treatment of children and teenagers, just as law enforcement has cracked down on the use of these drugs for recreational use.

"It should shock us all that we as a state have allowed and accepted that we are using powerful psychotic drugs on our children at an alarming rate," said Shumlin, a Democrat from Windham County.

Shumlin and Dubie joined Ken Libertoff, the executive director of the Vermont Association for Mental Health and a sharp critic of the doping trend, at Wednesday's press conference. Libertoff said he tried to jump-start the conversation over medicating children in 2007.

But a letter he wrote in March of that year to the Office of Vermont Health Access — the agency that oversees the state-run insurance programs such as Medicaid — seeking information on how many Vermont children are prescribed mental health drugs wasn't responded to until 11 months later, after a newspaper reporter asked about the delay.

''The question is, who is watching out for our children?" Libertoff said. "And my answer right now would be no one."

That information from OVHA, which Libertoff released to reporters Wednesday, gives a troubling snapshot of the trend in the state: Between April and September 2007, the state spent $10 million on anti-psychotic drugs for children through its insurance programs.

In addition, the documents show at least 6,200 Vermonters under the age of 18 who were taking at least one mental health drug. Libertoff said those numbers could be even higher because it only includes reimbursements through the state insurance programs.

He also bristled at what he called an inaccuracy in OVHA's letter this year to him that stated the "medications are approved by the Food and Drug Administration for the treatment of psychiatric disorders including those of children." Libertoff said most of the drugs in question have only been FDA-approved for adults.

"We raised a number of issues that should have been looked at, but were not," Libertoff said.

A call to OVHA was not returned Wednesday, but in its letter to Libertoff on Feb. 14, Deputy Director Ann Rugg apologized for not responding in a timely fashion.

Commissioner of Mental Health Michael Hartman agreed with Libertoff that the mental health system has a serious problem with prescribing psychiatric medications to children with little or no follow-up counseling.

That situation is compounded by the fact that the FDA often makes its regulation decisions based on studies and findings sponsored by the makers of the drugs, he added.

"It's not a good situation from top to bottom," Hartman said.

In response to the concerns, Hartman announced he is launching an inter-agency review of Vermont's medication prescribing patterns for children and teenagers. There is no timeline yet on this review, he said, and comparing the final data to what other states are experiencing will be difficult because there is no standardized reporting method.

"What we know is that as a country we have been escalating the use of these medications well above what was used a decade ago," Hartman said. "We have to stop this train."

Allowing children, whose bodies and brains are still developing, to take medications approved only for adults can be disastrous because of all the unknown consequences attached, according to Kathy Holsopple, executive director of the Vermont Federation of Families for Children's Mental Health, a nonprofit group.

More information needs to be supplied to parents before a child is prescribed psychiatric medications, she said. More research is also needed in this area, she added, to determine what the long-term consequences of this early drug use are.

"Children are not just little adults," Holsopple said. "We can't just give them adult medication."

Dubie, a Republican, took a more cautious tone than the others at the press conference Wednesday. He said he was troubled by the alleged overuse of psychiatric medications across the board — from children to prison inmates to senior citizens.

He pledged to be part of that dialogue at the state level aimed at "reducing the overall use of psychiatric medications in all areas."

"We must ensure that parents have access to timely and informed facts on the benefits and the risks of taking psychiatric medications," Dubie said.

Shumlin went one step further ashe vowed that lawmakers would look at the issue when they return to Montpelier in January 2009. He pointed to a newspaper report last month that the state spent $4 million on the drug Zyprexa in 2006, a medication that at least 10 states are suing the drugmakers over (Vermont is not involved in that litigation).

"We spent $4 million on this single drug when we all know that it has been challenged by many as a drug that has serious health consequences that were covered up by the maker," Shumlin said.

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