11 June 2007

Medicating Children

When you look through the profiles of children waiting for adoption, almost all make a reference to the child needing a parent who is able to advocate for their needs. The more "challenging" the child, or as the number of disabilities or behavioural issues increase, the emphasis on being a parent turned advocate increases, too.

By being a parent, I've become an advocate by default and have to negotiate systems and institutions with which I have zero familiarity. We're still working with Bella's school to resolve the bullying she faces. And, Wifey and I have had an ongoing struggle with Bubaloo's medical needs.

I'm a born activist. I like to think I'm pretty good at it. As an advocate for my children, I barely think I'm getting a passing grade. Mostly, I'm too overwhelmed and paralysed to the point of inaction by the sheer number of issues our kids face.

This article from Saturday's Globe and Mail on the disproportionate number of crown wards that are medicated reminded me of an outstanding issue we have yet to deal with regarding Bubaloo.

One month before we officially met Bella and Bubaloo as their adoptive parents, his foster parents placed him on an antipsychotic drug called risperidone. This is a drug that is prescribed to people living with schizophrenia, people trying to cope with the manic states of bipolar disorder, children and adolescents with autism and a variety of other anxiety disorders such as OCD, depression and Tourette's.

My son has been diagnosed with none of the above, nor are any of the above conditions being explored as possibilities for him.

Bubaloo is an angry child with poor impulse control. He often cannot articulate what he is feeling, so he shows it. He uses his body to get emotions out and often does so in highly inappropriate ways. He often is anxious and stressed when his basic emotional needs aren't being met.

In that month before we met Bella and Bubaloo as their adoptive parents, we had a conversation with our social workers and their foster parents and shared our opinion on medicating children. We don't agree that medication should be used to suppress behaviour that is emotionally driven.

Kids need to work their stuff out. And, medicating Bubaloo wouldn't give him that opportunity. As his new parents, we'd only ever know the child on medication and how were we to establish a baseline for who his is and what his normal behaviours are? We were clear that we didn't want Bubaloo to be put on any new medications prior to our adoption.

Two weeks later, the foster parents let us know that Bubaloo was on a new medication and it was working wonders for him. At his most recent pediatrician visit, Bubaloo actually articulated that he was anxious a lot and felt so angry at times that he couldn't control his rage. With both the foster parents and pediatrician delighted with this emotional sharing, a prescription was written for risperidone.

Practically overnight, Bubaloo's behaviour changed according to his foster parents. He wasn't hitting, kicking or lashing out at other kids at school when he got frustrated. He wasn't angry as much. He was a more tame and more manageable kid.

This rapid transformation brought into question whether or not it was actually the meds or the thought of the meds that was causing the behavioural transformation. Perhaps for Bubaloo, it was the idea that a little pill would fix everything and make it better that gave him the power of control over himself.

A little bit of research on this drug, thanks to my mother-in-law who is a nurse and has access to medical journals, revealed a body of literature that this drug is overprescribed to kids in foster care. There's no time and a lack of support in foster care to help the kids work through their experiences that lead to behavioural issues, so this drug is often prescribed to tame the behaviour and make kids manageable. It's an ingrained philosophy of "let's deal with the immediate behavioural issue instead of dealing with the root of the behaviour, or rather, lets deal with the effect and hope that the cause with work itself out."

Today, Bubaloo is still taking the risperidone and we haven't taken him off of it yet. There were so many battles for us to fight on his behalf when he moved in with us, so much change going on in his life, that we were advised not to wean him off of it just yet. It's an issue I've broached at the last two pediatrician appointments, but we often run out of time to discuss and plot a course of action because I walk into the doctor's office with a laundry list of issues.

Bubaloo's anxiety ebbs and flows. The past two weeks have been anxiety riddled. But, the 1-2 months before that were relatively anxiety free.

At one pediatrician appointment during a high anxiety time, the doctor suggested upping his dosage to two pills a day. We put our feet down and refused to medicate his issues away.

Bubaloo takes his little yellow pill each night before bed. By doing so, we've become complicit in what we would call an unnecessary, systemic medicating of our child.

1 comment:

Gawdess said...

It is sooooo hard.

We have finally taken our son down on his dosage of ritalin/concerta cocktail and it is a good thing but it took us months to get to the point where we could try it.

If things stay on an even keel for him I would like to try him at the lowest dose sometime in the next year.

Both of mine have far worse behaviours including adhd type ones when they are stressed.

Because they are both now homeschooled a lot of that stress is gone (not that hschooling is a cure all, it isn't and I am not trying to say it is) - it also means that I don't have to do the work of fighting teachers and principals etc.

Interesting stuff.