Anyone with an Internet connection can go online and see that Dr. Gold Smith Dorval is on probation with the Florida Board of Medicine and that his medical license was suspended because he stole money from Medicaid. Why, then, did the Department of Juvenile Justice allow him to treat children in state custody and prescribe powerful drugs for them?

DJJ’s inspector general should expand her already ongoing investigation into the department’s use of antipsychotic medications to answer that question. DJJ Secretary Wansley Walters ordered the inquiry after The Palm Beach Post reported that children in DJJ care are being prescribed heavy doses of the drugs.

A follow-up investigation by The Post’s Michael LaForgia showed that several of the psychiatrists doing the prescribing have troubled pasts that, by law, should bar them from working for the agency.

“We will look,” Ms. Walters said in an earlier interview, “at everything that surrounds this issue.”

Certainly, the qualifications of the doctors employed by the agency falls into that category. As The Post reported, some psychiatrists working for DJJ were cited for overprescribing drugs that led to patient deaths. A simple background check can reveal much about a doctor’s history. Even though DJJ requires such checks, in the case of Dr. Dorval and others, no one bothered.

DJJ does not have a system for tracking the medications taken by children in its care and has no way of knowing whether they actually need the prescriptions or if some of the doctors are drugging the kids simply to make them easier to control. When the doctor is someone like Charles Dack of Lakeland, who was disciplined for overprescribing drugs to a woman until she overdosed and died yet worked for DJJ until April, it’s easy to suspect the latter. And that’s unacceptable.

DJJ spokesman C.J. Drake said some doctors, such as Dr. Dorval, work for the agency through a third-party company. Those agencies should be required to prove that they have conducted background checks on all the doctors in their employ. Earlier this month, Georgetown University’s Center for Juvenile Justice Reform announced that Florida is one of four states selected to participate in its Juvenile Justice System Improvement Project. “The fact that Florida stepped up and applied,” said Shay Bilchik, founder and director of the center, “is a reflection of how seriously they take their responsibility.”

The seriousness with which the agency addresses this issue will be an even better reflection of its commitment to reform.

- Rhonda Swan,

for The Palm Beach Post Editorial Board

Then psychiatry’s image took a hit. The drugs of that time period were exhibiting serious side effects, people like Thomas Szasz were speaking out against psychiatry and the film “One Flew Over the Cuckoo’s Nest” was released. Psychiatry was lacking scientific respect at this time and needed a “makeover.”

In the late 1970’s, the medical director of the American Psychiatric Association (APA) said, “a vigorous effort to remedicalize psychiatry should be strongly supported.” He accomplished that with a big PR campaign and by ensuring this was reflected in the soon to be released third version of the Diagnostic and Statistical Manual (DSM) in 1980.

The DSM is the “bible” all psychiatrists use to diagnose mental illness. The first two versions in 1952 and 1968 respectively, are indicative of Freud’s theories and the book was pretty much used only by psychiatrists themselves. When DSM-III was being developed by the APA, this was abandoned and a new direction was deliberately taken to make psychiatry comparable to any other medical specialty and be on par with the rest of the medical community. The brain was now declared the source of all mental ills and drugs were the treatment.

Psychiatrists being medical doctors already have the ability to write prescriptions for drugs. However, some consistency was needed so that all psychiatrists would uniformly diagnose the same behavioral symptoms as the same mental disorder. DSM-III provided that tool. The book listed out multiple behavioral symptoms with corresponding numbers for 265 disorders so that all psychiatrists could diagnose the same disorder and prescribe a psychiatric drug for treatment.

Now that all psychiatrists were on the same page, the marriage of mental disorders and psychiatric drugs came to fruition. To make sure that marriage was going to last, DSM-III was put into the hands of insurance companies, hospitals, courts, prisons, schools, researchers, government agencies and other areas of the medical profession.

Psychiatrists may have been provided with the DSM as a reference for uniformity, but it’s only backed up by uniform opinions and not anything whatsoever scientific. There are no blood tests, urine tests, MRIs, x-rays or any other medical test you can think of to find the source of a mental disorder. However, all medical journals, articles, textbooks and the like are supported by scientific facts. We may have been pitched the idea that mental disorders are brain diseases and that psychiatry is a medical specialty, but without any scientific proof, basically we have been taken for a ride.

When a psychiatrist is trying to diagnose a patient he is looking for symptoms that fit a disorder in the DSM. The only problem is one symptom could qualify for several disorders which could mean several diagnoses and several drugs and more drugs to treat the side effects. Since there are no medical tests, opinions could change and as a result disorders could be redefined, symptoms rearranged or broadened, to fit any old form.

In fact DSM-5 which is due out in 2013 is doing just that. Already existing disorders such as Obsessive Compulsive Disorder and Schizophrenia are being expanded and generalized to include the word “spectrum.” Other disorders will have the word “risk” in them such as “psychosis risk syndrome” so the early stages can be treated with psychiatric drugs. If disorders continue to get more and more general and preventive, it won’t be long before there will be no distinction between normal and abnormal.

What is most shocking is that the choice of drug treatment is similar to rolling the dice. Psychiatrists admit that with only symptoms to refer to they try different drugs with no real idea of what they are trying to handle or if the drugs will be effective. Or perhaps your prescription is randomly made based on the day of the week because your psychiatrist feels like prescribing Cymbalta on Mondays and Lexapro on Thursdays for example.

The pill-popping culture of today may appear to have solutions for your emotional ills, but it would benefit you to get yourself educated on the marriage of mental disorders and psychiatric drugs and divorce yourself from it. Your life is too important to leave it to chance, lack of science and dangerous mind-altering drugs with severe adverse side effects.

A half a decade ago, mental illness was relatively rare, found mostly in mental institutions or out-patient clinics, not in the mainstream. A radically different scene exists today. Millions of school children, previously considered bored or unruly, are now considered to have a “disorder” and heavily medicated along with surprisingly high percentages of foster children, juvenile offenders, adult prisoners, soldiers, and elders in nursing homes. As well, a significant portion of the mainstream populace now turns to “meds” to solve battles with frustration, social shyness, learning difficulties, emotional ups and downs of life, etc. — struggles which, if confronted and conquered without drugs, might possibly strengthen the character.

Why this soaring trend of “mental illness” taking over society, along with billions of tax dollars to Medicaid and Medicare annually? New York Review of Books asks this very question in their article The Epidemic of Mental Illness: Why? by Marcia Angell, covering three books written in 2010 by mental health professionals:

The Emperor’s New Drugs: Exposing the Antidepressant Myth by psychologist, Irving Kirsch;

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by psychiatrist, Robert Whitaker; and

Unhinged: The Trouble With Psychiatry — A Doctor’s Revelations About A Profession in Crisis by psychiatrist, Daniel Carlat.

The in-depth review is by Dr. Angell, herself a medical doctor, who is a lecturer in the Department of Social Medicine at Harvard Medical School, Editor-in-Chief of the New England Journal of Medicine until 2000, and named by Time magazine, in 1997, as one of the 25 most influential Americans.

In her review, Dr. Angell questions the real reasons behind skyrocketing mental illness:

“What is going on here? Is the prevalence of mental illness really that high and still climbing? Particularly if these disorders are biologically determined and not a result of environmental influences, is it plausible to suppose that such an increase is real? Or are we learning to recognize and diagnose mental disorders that were always there? On the other hand, are we simply expanding the criteria for mental illness so that nearly everyone has one?

“And what about the drugs that are now the mainstay of treatment? Do they work? If they do, shouldn’t we expect the prevalence of mental illness to be declining, not rising?”

She further explains that the authors attack the subject from different viewpoints, but all conclude that the field of mental health is going in the wrong direction:

“The authors emphasize different aspects of the epidemic of mental illness. Kirsch…is concerned with whether antidepressants work. Whitaker…takes on the entire spectrum of mental illness and asks whether psychoactive drugs create worse problems than they solve. Carlat … looks mainly at how his profession has allied itself with, and is manipulated by, the pharmaceutical industry. But despite their differences, all three are in remarkable agreement on some important matters, and they have documented their views well.

“First, they agree on the disturbing extent to which the companies that sell psychoactive drugs—through various forms of marketing, both legal and illegal, and what many people would describe as bribery—have come to determine what constitutes a mental illness and how the disorders should be diagnosed and treated…
“Carlat refers to the chemical imbalance theory as a ‘myth’…and Kirsch, whose book focuses on depression, sums up this way: ‘It now seems beyond question that the traditional account of depression as a chemical imbalance in the brain is simply wrong.”

Her article reviews Dr. Kirsch’s discovery of scientifically improper drug trials:

“Altogether, there were forty-two trials of…six drugs. Most of them were negative…Yet because the positive studies were extensively publicized, while the negative ones were hidden, the public and the medical profession came to believe that these drugs were highly effective antidepressants.”

Dr. Angell quotes the third author, Dr. Whitaker, who describes how these drugs cause brain imbalances and greatly damage health, as opposed to curing anything:

“Imagine that a virus suddenly appears in our society that makes people sleep twelve, fourteen hours a day. Those infected with it move about somewhat slowly and seem emotionally disengaged. Many gain huge amounts of weight—twenty, forty, sixty, and even one hundred pounds. Often their blood sugar levels soar, and so do their cholesterol levels. A number of those struck by the mysterious illness—including young children and teenagers—become diabetic in fairly short order….All…neuronal pathways in the brain are compromised…studies find that over a period of several years, the virus shrinks the cerebral cortex [the outer layer of the brain]…and this shrinkage is tied to cognitive [relating to mental activity] decline….Now such an illness has in fact hit millions of American children and adults. We have just described the effects of Eli Lilly’s best-selling antipsychotic, Zyprexa.”

This enlightening article by Dr. Angell summarizing the important issues made in these books help us understand what is really behind this seeming increase in mental illness and its apparent need for drugs, drugs and more drugs. In the end, we may well wonder if the most influential factor behind this whole scene is an ingenious marketing campaign by pharmaceutical companies to create a continually expanding client base and soaring profits.

Reference:

http://www.nyrb.com/articles/archives/2011/jun/23/epidemic-mental-illness-why/?page=1

In an article by John Kelly written for YouthToday , this alarming information was reported,

“A ground-breaking, year-long investigation by Youth Today has uncovered ample evidence that many youths incarcerated in American juvenile facilities are getting potent anti-psychotic drugs intended for bipolar or schizophrenic patients, even when they have not been diagnosed with either disorder.”

Mr. Kelly quotes Robert Jacobs, a former Florida psychologist who now practices in Australia,

“Fifty years ago, we were tying kids up with leather straps, but now that offends people, so instead we drug them. We cover it up with some justification that there is some medical reason, which there is not.”

Michael LaForgia of the Palm Beach Post has researched this trend in Florida’s Department of Juvenile Justice (DJJ) and reports,

“In some cases, the drugs are prescribed by contract doctors who have taken huge speaker fees and other gifts from makers of antipsychotic pills, companies that reap staggering profits selling medications. ¹

“The medications have poured out at such a rate, said one former inmate, that even a confused teenager could tell that this wasn’t how things were supposed to be.”

In treating at risk juvenile delinquents, the pharmaceutical industry has discovered a gold mine.

Mr. LaForgia declares,

“In 2007, for example, DJJ bought more than twice as much Seroquel as ibuprofen. Overall, in 24 months, the department bought 326,081 tablets of Seroquel, Abilify, Risperdal and other antipsychotic drugs for use in state-operated jails and homes for children.

“That’s enough to hand out 446 pills a day, seven days a week, for two years in a row, to kids in jails and programs that can hold no more than 2,300 boys and girls on a given day.”

What are the possible side effects of Seroquel for a young person? Mr. LaForgia states,

“The pills can cause suicidal thoughts in kids, as well as weight gain, high blood sugar, diabetes, heart problems and uncontrollable facial twitches and body tics, clinical trials have shown.”

One hopes the juvenile delinquent problem will be handled, not hidden by the use of debilitating psychiatric drugs.

Resources:

1. http://www.palmbeachpost.com/news/state/huge-doses-of-potent-antipsychotics-flow-into-state-1490021.html

A recent article from The American Lawyer Academy discusses the continued unethical and dangerous use of psychotropic drugs on seniors.  Rather than providing seniors with the care and compassion one would expect, such “care” often takes the form of strong psychiatric drugs — making life easier, not for the senior, but for their caretakers.

Elderly Couple**

Per Chemical Restraints to Control Seniors in Nursing Homes,January 27th 2011 by John Bisnar,

“If you put your beloved parent, grandparent, aunt, or uncle into a nursing home, how would you feel if you found out that the nurses and doctors at the home tied them up to a bed or wheel chair? How outraged would you be if you knew that the people you’re paying to look after the well-being of your loved one were physically restraining them just so they would be ‘less of a bother?’ According to a recent report from the American Association for Justice entitled, ‘Standing Up for Seniors: How the Civil Justice System Protects Elderly Americans’, it turns out that what is happening in nursing homes with increasing frequency is not that far off. Instead of using ropes and chains though, nursing homes are using chemical restraints on seniors  — psychotropic drugs that sedate or control behaviors.

“According to the Standing Up For Seniors Report, the use of chemical restraints has been on the rise in the last few years. This is very disturbing to note. In addition to the injustice of getting the drug equivalent of chains and a muzzle, the consequences of chemical restraints are dangerous and even deadly for seniors. The use of antipsychotic medication for chemical restraining has been linked to problems like falling, confusion, delirium, hospitalizations, and even death.”

The weakened state of the elderly might alert one to the dangers of strong measures used to “treat” them.  Yet this practice required an FDA 2005 public health advisory warning that using these drugs on elderly dementia patients cause premature death.  FDA therefore demanded black box warnings* for a number of drugs being used on seniors.  This unethical practice, however, is still found to exist.  In the case of Robert Harris, in a California nursing home, it was part of the mix that led to his death. The American Lawyer Academy article further explains how:

“In one particularly tragic case, a dementia patient suffered the ultimate price for chemical restraining. The patient, Robert Harris, had been described as ‘lively’ and ‘energetic’ before he entered the nursing home. Those who knew him described him as a regular “grumpy old man.” His grumpiness was evidently too much of a bother for the nursing home staff. The doctors categorized him as psychotic and needing to be ‘chemically restrained.’ The nursing home placed Harris on two strong antipsychotics which caused him to become “an involuntary catatonic prisoner.” He stopped eating and drinking normally and lost 10% of his body mass within a month. The drugs made him go from being active and talkative to drowsy and confused. The drugs made things ‘easy’ for the staff, but they killed Harris’ spirit. Eventually Harris developed incontinence and needed a catheter. The catheter was inserted incorrectly, punctured his urethra, and caused a massive infection which eventually killed him.”

Aging patients, unable to care for themselves physically, are often removed from their own homes, away from family and friends.  Out of their familiar, friendly environment, they naturally can become both upset and disoriented.  However, labeling their “demented” state of mind as psychotic and using heavy antipsychotic drugs is now the subject of scrutiny and continued investigation.  Anyone seeking care for aging parents or relatives should be alert for nursing homes resorting to such practices.

* Black Box Warnings by FormWeb

**Photo Credit: Copyright (c) 123RF Stock Photos

So how did antipsychotic drugs get into mainstream use?  According to this article, the answer is by illegal marketing.  A drug company can’t promote a drug for anything other than what the FDA approved its use for, but a doctor, paid consultant, researcher or educator can.  In fact, sales reps “wine and dine” doctors to promote their drugs or do a “study” and in return get money, gifts, trips and the like.  Or the marketing department can come up with a “study” for them and then pay a prestigious doctor a significant fee to sign it so it looks like a doctor did the “research.”  A Harvard educated psychiatrist was a paid speaker for several drug companies and turned into a government informant.  He said he was paid $1000 or more to talk to a doctor about a drug.  It got to the point that he was asked to say things that weren’t true.  He was asked to show slides that stated a new antipsychotic drug had no neurological side effects.  “They made it all up.  It was never true.”

Now under the False Claims Act, every major drug company selling antipsychotics is being sued by the government for health care fraud or they have recently settled a case for hundreds of millions of dollars.  Eli Lilly just got slapped with a $1.415 Billion fine for its all-time best-selling drug Zyprexa.  Apparently it was knowingly being promoted for uses not approved by the FDA and they even made a video called, “The Myth of Diabetes” to discredit the fact that Zyprexa could cause diabetes among other side effects.

Yet with over 1,000 lawsuits in progress, the drug companies admit no wrongdoing and claim their drugs are safe.  With the above information in mind, I would suggest checking out for yourself what are the TRUE factual risks and benefits of any drug before becoming a victim of marketing over safety.

Sources:

http://us.macmillan.com/medicationmadness

http://www.nytimes.com/2010/10/03/business/03psych.html?pagewanted=2&_r=3&hpw

We do not know the answer to that, but it is a fact that the use of psychiatric medication by the armed forces has increased 85% between the years 2003-2009.  A senator from Maryland stated in this article, “There’s been an increased use of antidepressants and other medications, and there’s been a significant increase in the number of suicides and attempted suicides.  Intuitively, it just tells you that there’s a connection.” 

The FDA’s Black Box Warning on these drugs warns that they could increase suicidal thoughts.  Is it not bad enough that our troops are over there looking death in the face everyday, but now they are being treated with powerful mind-altering drugs that could cause suicidal thoughts? 

The wife of one veteran who, fortunately, did not commit suicide quoted her husband as saying, “It all started to get worse when I got on this medication [an antidepressant].”  

Given the above information, it would follow that this war is not worse than Vietnam or any other war before it.  It is the addition of psychiatric drugs.  Look over the information and decide for yourself. 

Source: National Journal, “A Prescription For Tragedy” October 2, 2010

But doctors need not wait for FDA approval to prescribe a drug off-label, and when it came to poor children, they certainly did not wait for the FDA to approve atypical anti-psychotics. Ken Kramer, a researcher with the Citizens Commission on Human Rights of Florida, obtained detailed annual Medicaid expenditures for the five most prescribed atypicals in 30 states.

Youth Today
Psych Meds In Jails

The findings are derived from records of state juvenile systems that provided sufficiently detailed information on their use of these anti-psychotics – called “atypicals.” Only 16 states responded to a nationwide survey by Youth Today, meaning that a majority of states either would not or could not demonstrate that they were even monitoring the use of these medications on incarcerated juveniles.

The atypical anti-psychotics were being used to treat a wide variety of diagnoses, including intermittent explosive disorder, oppositional defiant disorder and even the more common attention deficit and hyperactivity disorder.

Critics believe most of these diagnoses are simply a cover for the fact that prisons now use drugs as a substitute for banned physical restraints that once were used on juveniles who aggressively acted out.

“Fifty years ago, we were tying kids up with leather straps, but now that offends people, so instead we drug them,” says Robert Jacobs, a former Florida psychologist and lawyer who now practices psychology in Australia. “We cover it up with some justification that there is some medical reason, which there is not.”

Supporters of prescribing the atypicals believe using the drugs as sedation isn’t necessarily bad.

“It prepares youth so they can respond to treatment,” says LeAdelle Phelps, a former juvenile facility director and adolescent psychologist. “By reducing aggression and by having calming, soothing effects,” the anti-psychotic makes residents “more malleable.”

Others disagree, arguing that the drugs may interfere with attempts at meaningful therapy.

But there have been no studies on widespread use of the atypicals on juvenile offenders. The Government Accountability Office is investigating various state policies for placing foster children on atypicals, which in those cases are paid for by federally matched Medicaid.  

But federal Medicaid money, by statute, cannot fund care for anyone incarcerated for a crime – adult or juvenile. That means funds for medications issued to juvenile inmates come from state sources. 

For more than a year, Youth Today has been working to find out how much states have been spending on anti-psychotic drugs for incarcerated juveniles, and why. 

A recent article exposes there are factions within the psychiatric community of educated experts who have somehow escaped party line brainwashing and refuse to go lock-stepped over a professional cliff but rather have filed formal protests strongly questioning whether psychiatry as a whole has lost its collective mind.

 “Mental health experts ask: Will anyone be normal?”

“(Reuters) – An updated edition of a mental health bible for doctors may include diagnoses for “disorders” such as toddler tantrums and binge eating, experts say, and could mean that soon no-one will be classed as normal.

The scientists gave examples from the previous revision to the DSM, which was called DSM 4 and included broader diagnoses and categories for attention deficit hyperactivity disorder (ADHD), autism and childhood bipolar disorders.

This, they said, had “contributed to three false epidemics” of these conditions, particularly in the United States.

“During the last decade, how many doctors were harangued by worried parents into giving drugs like Ritalin to children who didn’t really need it?,” their statement asked.

Millions of people across the world, many of them children, take ADHD drugs including Novartis’ Ritalin, which is known generically as methylphenidate, and similar drugs such as Shire Plc’s Adderall and Vyvanse. In the United States alone, sales of these drugs was about $4.8 billion in 2008.

Wykes and Callard published a comment in The Journal of Mental Health expressing their concern about the upcoming DSM revision and highlighting another 10 or more papers in the same journal from other scientists who were also worried.”

If one would step far enough off the social curb deep into the sewer to study psychiatry closely and learn their language, it might be fitting to suggest they are suffering from a severe case of ESMAD Exposed Social Menace Anxiety Disorder.

Foster kids lose

Still subject to over use of psycho-tropic drugs

May 1st, 2010

State Sen. Rhonda Storms, a Valrico Republican, put up a Herculean fight on behalf of Florida’s foster kids this week, but a powerful bloc of doctors and psychiatrists defeated her in the Florida House.

The House leadership could have prevented this travesty. Instead, it caved to Florida’s powerful medical lobby and sacrificed some of the state’s most vulnerable residents.

The battle was over use of psycho-tropic drugs on youth in state care. After the 2009 suicide of 7-year-old foster child Gabriel Myers in Margate, the Department of Children & Families hired former Florida Department of Law Enforcement Deputy Commissioner Jim Sewell to investigate how drugs are used to control unruly foster kids.

Mr. Sewell pulled no punches in his report. Foster parents and doctors often resort to strong anti-depressants to keep children with emotional problems in line. Treatment of their underlying psychological problems take second place to keeping them drugged up.

Gabriel had been prescribed several such drugs before he hung himself, including anti-depressants linked to an increased risk of suicide among children.

The DCF sought better oversight of how doctors prescribe psychiatric drugs to foster children. The bill, sponsored by Sen. Storms, would have required doctors to seek the “assent” of older foster kids before they could be medicated and upheld current law requiring doctors to get consent from a parent or a judge in most cases before using drugs.

That’s reasonable – and, more important, in the child’s best interests. But physicians fought, saying they didn’t want government telling them what to do. Republican state Rep. Paige Kreegel, a Punta Gorda doctor, blocked the bill from even being heard in the House, though it had passed easily in the Senate.

Sen. Storms tried every legislative maneuver available to get around Rep. Kreegel, but the physicians won the day, and Florida’s foster children are worse off for it.

DCF ought to seek another way to control use of these medications until reason prevails in the House.