To Drug or Not to Drug – Not an Easy Call

Day 047/366 - February 16th
Creative Commons License photo credit: Amanda M Hatfield

It seems like every few months there’s a news story that looks at the way we as a nation medicate our kids—the increasing rates, the negative side effects that can come with medication, the off-label usage. All of it raises questions about the ways meds affect our children’s health and development. These stories are thought provoking at the least, utterly disturbing at the worst.

But who doesn’t know someone—perhaps it’s even in our own family—who has lived through the havoc that a serious mental or behavioral health problem can bring? Many families manage to reclaim a sense of healthy functioning after their child receives medication.

While there are some who argue against the use of any mind-altering medication in treating a child for mental or behavioral disorders, research backs what many children and their families witness firsthand—these medications often work. They can be effective in alleviating symptoms and treating problems that previously represented huge obstacles in a child’s ability to function at home, learn at school, or even live safely with family.

Still, there are those disturbing things, too. Some of the drugs are prescribed off label. Many have side effects. Parents need to weigh the benefits the drug provides with any side effects or risks that may come with it.

Like the rest of the nation, Texas has a severe shortage of child psychiatrists, and many parents turn to their pediatrician or family doctor for help in navigating these decisions. In fact, most prescriptions for psychotropic medication for children are written by pediatricians and family physicians, and not by child and adolescent psychiatrists, who have the most training in the appropriate use of these kinds of medications.  While primary care doctors play a critical role in addressing children’s mental health, many may find themselves ill-equipped to help families address the complex issues and needs that often come with serious children’s mental health concerns.

So while medication is a valuable tool that, when used appropriately, has its place in many children’s treatment plans, there are real concerns that children are being inappropriately prescribed medications when other treatment options could—and perhaps should—be used.  Several things may be playing into this. Doctors may be using the tool they are most familiar and comfortable with (you know, just like how carpenters like hammers, surgeons like scalpels…). Pharmaceutical companies are very adept at marketing to both doctors and parents, so not only are doctors are being to encouraged to prescribe the “latest and greatest” medication on the market, but parents desperate for solutions are now coming to their child’s doctor’s office asking for specific meds. And sometimes, well, a pill may just be a more convenient and cheaper way to fix a problem than using other, more appropriate, and less intrusive interventions, such as talk therapy or giving parents and teachers training and tools that help children manage their symptoms.

Perhaps most troubling are reports suggesting some kids are at particular risk of being overmedicated.  A recent federal report found that kids in the Texas foster care system are prescribed psychotropic meds at higher rates than kids in the foster care systems of other states.  This is even after Texas put in place some good policies to bring down its foster care prescribing rates (Texas’ rates have gone down, but we’re still higher than the other states). A couple of years ago, the New York Times reported low-income children covered by Medicaid were prescribed antipsychotic drugs four times as often as their peers covered by private insurance, and that these low-income children were more likely to be handed a prescription for smaller concerns.Advertisement
As if having a child with mental health or behavioral concerns isn’t hard enough, parents find themselves having to make some tough calls on treatment decisions on what’s best for their child.  What can they do?  Well, I’m not expert, but I say:  Ask questions and research options.  Become educated, and be informed on both your child’s diagnosis and the different treatment options available to your family.  Medication may be the right choice, either alone or in combination with other strategies, or it may not be.  But always, ALWAYS advocate for what your mama-instinct is telling you your child needs—at their doctor’s office, with their therapist, and at their school.

Here are a few resources that might be of some help:

It’s also important for parents to advocate for their children at the Capitol, because decisions made at the Legislature affect the type of care that’s available in our communities.  There are real actions our state lawmakers can take to attract and keep good doctors and child psychiatrists in our state. They can help make sure other people who work with our children—like child care providers and teachers—have information and resources they need to help children with concerns.

Our lawmakers can also take action to increase the availability of effective mental health services and supports available in our communities, so that parents have real options when deciding what’s best for their children—and don’t have to settle for the first treatment that’s offered to them.

Written by: Josette Saxton

About Christine Sinatra 53 Articles
Christine Sinatra is the communications director for Texans Care for Children and mom to a kindergartener. Her past experience includes working as a reporter for the Austin American-Statesman and the Oakland Tribune company, being a Peace Corps volunteer for high school girls in Africa, and studying at UT’s LBJ School of Public Affairs.

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