Journalism in the Public Interest

In Some States, Incarcerated Kids Get Drugged to Alter Behavior, Despite Risks



Though the use of antipsychotic drugs on children is believed to carry significant risks even when used properly to treat bipolar disorder and schizophrenia, it’s not uncommon in some states for juveniles in detention to be prescribed antipsychotics simply to counter mood disorders or aggressive behavior, according to an investigation by Youth Today, which covers the juvenile justice system and youth services.

Data on antipsychotic expenditures and individual diagnoses show that for juvenile detention facilities in Connecticut, Louisiana, New York, Texas and West Virginia, 70 percent of prescriptions were filled for conditions other than bipolar disorder and schizophrenia — the disorders for which these drugs generally are FDA-approved. (Doctors can still prescribe the drugs for off-label uses, or to treat conditions for which they have not been approved.)

Most states, when surveyed, either could not or would not demonstrate that they were even monitoring the use of these drugs on incarcerated juveniles, Youth Today reported. Of the 34 states that provided no answers when queried, 16 refused to answer.

A piece in The New York Times over the weekend provided additional context on the subject. Over the years, drug companies have aggressively marketed second-generation antipsychotics — known as “atypicals” — to be safer than the first-generation drugs. While some side effects appear to be less severe, the atypicals have a range of other side effects, and the safety claims regarding these second-generation drugs have been “greatly exaggerated,” Jeffrey Lieberman, chairman of Columbia University’s psychiatry department, told the Times.

The industry’s response? Again from the Times:

The drug companies say all the possible side effects are fully disclosed to the F.D.A., doctors and patients. Side effects like drowsiness, nausea, weight gain, involuntary body movements and links to diabetes are listed on the label. The companies say they have a generally safe record in treating a difficult disease and are fighting lawsuits in which some patients claim harm.

In recent years, four major drug companies Bristol-Myers Squibb, Eli Lilly, Pfizer and AstraZeneca — have settled lawsuits brought by the government, which accused them of illegal practices related to the marketing and promotion of antipsychotic drugs. Some of these lawsuits were related to promotion of off-label use — which doctors may prescribe, but drug makers are not allowed to promote once a drug has been approved by the FDA for specific uses.

Youth Today’s report raised the question of whether these drugs are being used off-label as chemical restraints or sedatives for youth with behavioral problems that could be treated more effectively by other means. Not all psychologists have a problem with the use of antipsychotics to alter behavior, the piece pointed out:

Adolescent psychologist LeAdelle Phelps … has been involved in the juvenile justice system for decades — first as a girls program director in Utah and more recently as a professor at the State University of New York-Buffalo — and she views the atypicals as an important means to an end: ushering juveniles to a mental place where they are amenable to psychotherapy.

Asked if she thinks the diagnosis used to establish a prescription mattered, Phelps replies bluntly, “Not really. … In the end, what you’re trying to do is get him to be responsive to treatment. By reducing aggression by having calming, soothing effects, it makes [the youths] more malleable.”

But others expressed concern about the risks, especially to youth:

“I’m concerned about using [atypical] medications with any adolescent,” says Ron T. Brown, former dean of the Temple University College of Health Professionals, now provost and senior vice president at Wayne State University. 

… The way to think about using atypicals for youths is in terms of risks and benefits, explains Olfson. If an anti-psychotic does not address the patient’s problem, he says, the “benefit derived is vanishingly small or nil. But the risks are going to be the same, roughly, whether you have a psychiatric illness or not.”

Studies have shown it is cheaper to medicate children than to pay for counseling, which is why children from low-income families are four times as likely to receive antipsychotic drugs compared to the privately insured, according to the Times.

so glad Ms. Phelps’ comment was included for context. helping a raging, depressed, or disassociated teen calm down, eat and sleep normally, and regroup makes that person more receptive to counseling. also to advice, to nurturing and to healthy peer interaction (to say nothing of schoolwork.)
hysterics who go bonkers over “kids doped into submission on meds!!” miss this key point. they also miss the point that the higher percentage of teens on meds in foster care or juv justice system may have had untreated issues that helped land them there. that is why there are so many more in that status receiving multimodal treatment.
a first step is never seen as a full solution, and is not intended as such. there is no wisdom in having precious therapy hours wasted on a teen who is in full bloom of agitation or violent. there is tremendous value in having the path smoothed, by meds and a good sleep cycle, for therapy.
the goal is solving problems using a combination of therapy, group or solo; food-sleep-fitness routine; meds when needed; and social & academic skills training.
carving out one slice of this matrix for derision significantly misstates the reality of solution-based intervention and undercuts the value of a holistic approach.

Does the author of this article think drugs are NEVER to be used? If so, how about coming back to earth?

Shouldn’t there be a child’s advocate to take this to court?

What if a child is deathly allergic to the drug?

Shouldn’t we find out WHY these children are behaving the way they are?

Starry and Stevo,

Too often these drugs don’t work, they just make the child druggie, and nothing gets accomplished to help these kids. I’ve seen it first hand.

What happens when it’s time to free these kids? What happens to the safety of our society once these kids are out of prison?

I suggest that we find out HOW these kids learn, what made them behavior problems? It should always be WHY, not just what.


Yes, in an “ideal” world, we’d have parents who really are “parents” and weren’t on drugs that messed up their kids. Also, if we had more “manpower” to work with the kids, their problems might EVENTUALLY be solved to make them functioning kids who became functioning adults.

I don’t see that happening, though. Every day on the way to work I see homeless people whose brains are messed up, either from their parents or from taking drugs, and there’s way too many of them.

Back in the “old days”, families/communities “took care” of “their own”. The world is too complicated and too many are just “surviving” to be able to do much more than not become one of those people.

Child psychiatrists and other doctors who prescribe neuroleptics, antidepressants and addictive stimulants (e.g.,Ritalin) to children - whether or not approved by the FDA or Health Canada - should be charged and convicted of child abuse, medical negligence and lose their medical license.

So what you are posting Stevor that because these kids don’t have good parents they don’t deserve to be tested? To have any kind of help?

Instead drug them up and when we let them go to be with society and they can’t cope, OH WELL TOO BAD.

Apparently you know very little about this situation. To do it my way would actually be less expensive in the long run, and certainly safer.

We need to pay more attention to the consequences of what we do in the beginning, or our prisons will be even more crowded than they are now.

More and more taxes going to paying for new prisons.

I suggest thinking more about this before you give answers that most likely will make things worse.

I’m neither physician nor shrink, but I have observed teens and kids with severe behavior problems.

What do these lay people want the prison officials to do with these kids—put them in straight jackets?  Lock them in solitary?  Chain them to a post?

That’s the way severely disturbed kids and adults used to be treated and still are in some parts of the world.

I’m neither physician nor shrink, but I have observed teens and kids with severe behavior problems.
to do with these kids—put them in straight jackets?  Lock them in solitary?  Chain them to a post?
What do these lay people want the prison officials

That’s the way severely disturbed kids and adults used to be treated and still are in some parts of the world.

I agree Don. When my daughter’s pediatrician prescribed cylert and then ritalin to my daughter both gave bad reactions to her.

btw, the year I was “in” was 1967.  Plenty of time to change things around you’d think.

I’m afraid the problem may not always be the children.  Sure, it is some of the time, but the other part of the time it just might be a defective/toxic home environment with parents who either don’t care or haven’t got a clue how to raise children.

And then its the child who takes it on the chin, gets locked up somewhere with NO or questionable “therapy”.

I am sorry to say I think children are still subjected to the same abuse.  Sometimes the parents want the child out of sight out of mind, or else possibly even for vengeance/control.  There are good parents and not so good parents and then there are bad parents.  Sometimes these places are used by parents as a control mechanism not because they care but to say “gotcha”.

Great article Marian!
This is what I call real investigative journalism.

good article. the idea of drugging children so they are easier to deal with is insane. these drugs are amphetamines. they calm them down because they make the children high. only the worse kind of people give these drugs to children. If dealing with and helping delinquent children is to hard for a person find someone with a heart who can deal with them.
I have worked in juvenile detention centers with children. they are most the time victims of awful parenting or wards of the state. and the state is a terrible parent. we cant lock these children behind bars and drug them. this is just barbaric to think about.

Hey Marco,

How bout giving some credit where credit is due? Marian is simply re-blogging the investigative work by Youth Today and the New York Times. Obviously the point here is that people like yourself find out what’s going on inside state facilities, but come on now, I think you are equally capable of copying and pasting articles onto your own blog, Marco. Perhaps then I would say bravo to you.

It’s good to see the shills on here who back the drugging of children even though the drugs they are given are dangerous, and the proper clinical diagnoses and monitoring are absent. These pro-drugging shills are part of the Brave New World, 1984, Clockwork Orange crowd. And this is just the tip of the iceberg. The psychiatric drugging of America’s youth is an epidemic, encouraged by schools, and of great profit to Big Pharma. I hope you shills are happy!

Drugging of people in institutions -adults and children is more commonly used WITHOUT ‘counselling’.‘Counselling’ may exacerbate problems making inmates more violent,difficult etc. They might attack the counsellor-or others.The counsellor or teacher or doctor may have more problems than the child or adult and much of the ‘improper’ behaviour may be a reaction to that.‘First do no harm’ is forgotten in the rush to.get people under control.Patients admitted to acute facilities are routinely given 1200mg Chlorpromazine which can cause dangerously low blood pressure,irreversible Tardive dyskinesia,producing a zombie-like state.Incompetent psychotherapy in the vulnerable can result in ‘decompensation’ .making the person even less accessible .If left alone-ie, not ‘hassled’-many patients make their own recovery in their own time.Even in 2010 the old ‘Bedlam’ sign ‘abandon hope all ye who enter here’ is still relevant.

I remember when I lived in an orphanage or boys home for about 2 years during my teenage years some of the kids were given medication to control their behavior.

We must constantly distinguish the effects of different medication.  Antipsychotics replicate many of the same behaviors as alcohol, while prescription stimulants (which are NOT addictive) are almost the same as long lasting caffeine.

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