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PRESCRIPTION FOR TRAGEDY

Brothers, Ages 4 and 5, Are Fed Daily Routine of Pills

In a groups home, the boys get drugs with regularity. Experts say the story is repeated across the state.

May 17, 1998|TRACY WEBER | TIMES STAFF WRITER

At 5:30 a.m., the street lights are still on outside the Tustin group home where 5-year-old Steven, warm and rumpled from his bed, gulps down his first Ritalin dose of the day.

Half an hour later, the drug's effects have yet to take hold, and Steven, in his pajamas, is hopping like a frog on the couch, doing flips off the arm--like any rowdy kindergartner.

"He should calm down pretty soon," says a child-care worker.

At 6:45, two workers lead a breakfast table cheer when Steven's sleepy-eyed little brother, Kenny, 4, swallows an orange Dexedrine pill on his first try.

"All right, Kenny!"

Throughout the day, Steven will pop pills with the regularity his parents once chased a methamphetamine high. He will be given Ritalin three more times to control hyperactivity; Mellaril, an anti-psychotic, twice; and clonidine, to counter the insomnia caused by the Ritalin, at bedtime.

Kenny will take Dexedrine, another anti-hyperactivity drug, two more times. It is the brothers' daily routine.

Social workers took Steven and Kenny from their mother three years ago, after they were found half-naked, covered with lice and bruised. When social workers arrived, Kenny was playing with a six-inch knife in an apartment strewn with garbage.

To protect the two boys, the county placed them in a group home for abused children. But there, no one protected them from the child welfare system, say a number of child psychiatrists and children's advocates.

The story of Kenny and Steven takes place in Orange County, but it is repeated over and over in California group homes and foster homes every day, experts say.

The dosages and the combinations of drugs given to Steven are "too much," says Dr. Thomas Hicklin, head of the child psychiatry ward at the Los Angeles County-USC Medical Center after learning of Steven's prescription amounts. "I think it's dangerous."

Hicklin also questions why Steven, who weighs just 56 pounds, was being given both clonidine and Ritalin after researchers from UCI and UCLA published articles saying the combination had caused sudden death and heart problems in a small number of children. "I wouldn't use that medicine in that combination," he says. "Why risk it?"

Dr. James McGough, an assistant professor of child psychiatry at UCLA, who also reviewed the boy's medications, agrees: "All they're really doing is putting him in a chemical straitjacket. . . . There are no studies that show a 5-year-old benefits from Mellaril."

There are nearly 3,800 Orange County kids living, by court order, with relatives other than their parents, with foster families or in group homes. Hundreds of these children are given psychiatric drugs tested and approved only for adults.

County officials don't keep track of how many of these children are given psychotropic medications, or of the problems children experience with them. Of the children whose cases The Times reviewed, some were being given prescriptions that didn't match their diagnoses. Others, like Steven, were given drugs in dosages or combinations that a number of prominent child psychiatrists found excessive and dangerous.

Contrary to state law and the practice in some California counties, Orange County's judges do not personally inspect and approve requests to drug children under their care. Instead, they have relegated that responsibility to Department of Children and Family Services managers with no special training in the use of such drugs on children.

When asked, several older children listed a raft of potent medications they had been given that did not appear in their court files. And children were given drugs without the knowledge or consent of their social workers, their attorneys or their biological parents.

Mary Harris, deputy director of the county's Department of Children and Family Services, says she is not confident that her agency knows every child that is receiving psychiatric medications. The group home doctors often refuse to share the medical records of children under their care with social workers.

"We believe we have the legal authority to see the records, but it's easier said than done," she says.

Even the Toddlers Want Their 'Meds'

Whereas such medications were once the rare exception, reserved for the severely emotionally disturbed, depressed or hyperactive, they now are a common sight to abused children. At the county's temporary shelter, the Orangewood Children's Home, children as young as 3 are medicated several times a day to control their depression and rage, as well as their sniffles and infections. At times, all the children at Steven and Kenny's group home are given psychotropic drugs, and even a 22-month-old knew the word "meds."

In Orange County, the inability of the county to monitor children's medications occurs at the most basic level.

Many children are first assessed and treated at Orangewood, where one therapist says she feels pressured to diagnose troubled--or merely troublesome--children with something.

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