medicating children

[southern granny]

Is this what our world has become?  We were doing garage sales this morning and in a very nice neighborhood a mother and her son (approx 10-11) were having a sale.  The boy was talking and playing but doing nothing that was unusual and then the mother goes on a rant about how much he was talking and figiting and says "I've had enough, I'm going to get your medicine" and she brought him a pill and made him take it even though he didn't want to.  Really,  a ten year old boy can't be a regular boy without his mother pushing a pill down his throat.  It made me very sad and I will probably be thinking about it all day.  I just feel so sorry for that boy.

[La Bibliotecaria Feroz]

With the caveat that obviously we don't know their full story, that does sound really sad. I'm sure medication is a miracle for some families, but...

[gooki]

We have a family rule for our children. Hugs not drugs. This served us well when they were teething. It's all to easy these days to load them up with Pamol and Bongella then send them to bed. Instead we spend time with them, even if it means sharing the bed all night. Because like wow that's such a hard thing to do.

Now a handful of times the pain was too much for them, and we would use either of the options, but it felt right knowing we had tried the alternative.

[Psychstache]

With the caveat that obviously we don't know their full story, that does sound really sad. I'm sure medication is a miracle for some families, but...

+1

I have been working in special education for almost a decade now. Are there some kids who could be successful if their parents focused on other strategies instead? Yes.

Are there parents who have children with conditions like ADHD, Bipolar Disorder, Anxiety Disorder, Depression, etc. who have seen there kids lives improve 1000x fold as a result of finding an appropriate medication? Yes.

[justajane]

It sounds sad, but I've learned over the years that it is not helpful to me or them to judge the situations of strangers. After your short observation of them, you really have no idea what their situation is. I'm not saying your sadness isn't a valid emotion, but it might be misplaced.

We have two close friends who medicate their kids, one of whom is a pediatrician, because their kids are on the spectrum and tend to fly into a rage often. In many cases, medication is absolutely indicated and has made life better for families.

Years ago these kids were often institutionalized or family life just became miserable for all, including siblings. But now, because of medication and other therapies, they are able to live more in harmony with each other and stay in the home. I count that as a success, although I am sure there is some mismanagement of this tool we have.

[Cathy]

The problem with administering psychotropic drugs to children is that it might be done for the benefit of the parents or the "family" rather than specifically for the benefit of the person taking the medication. In my view, it's wrong for parents to administer medication to children calculated to make life better for the parents at the cost of making life worse for their children (for example, by introducing difficulties sleeping, perpetual exhaustion, weight gain, reduced cognitive ability, depression -- all common and well-documented effects of psychotropic drugs).

As for not judging the situations of other families, consider this. What if you saw parents viciously assault their children? I bet you would be concerned about that. Administering drugs is a lesser violence and may not be illegal (although in some situations, it might be), but it's still something that we should be concerned about, not something that parents should be allowed to do without criticism.

I'm sure parents who beat their children believe they have very good reasons for doing so as well. Some of those parents might even be physicians. Physicians don't have a monopoly on ethics. The administration of psychotropic drugs should only be done with the consent of, and for the benefit of, the person who is taking the medication, not for the benefit of other parties (such as parents or "the family"), because otherwise it is a very significant violation of personal liberty to inject foreign brain-altering substances into a person's body (even if it's legal in the circumstances, it may be unethical).

[forummm]

I think the overmedication is because 1) it's very profitable for pharma and they advertise in the right places and to the right docs, 2) school teachers don't want to deal with kids being kids and they are quick to demand medication, 3) kids eat too much sugar and refined carbs that behave as sugar so they are all hopped up and irritable and can't concentrate, and 4) being a parent sucks at times because kids don't behave how you'd like and it's easy just to give them pills.

I think it's very dangerous and is likely to change the kid's brain chemistry for the long run.

[Letj]

The problem with administering psychotropic drugs to children is that it might be done for the benefit of the parents or the "family" rather than specifically for the benefit of the person taking the medication. In my view, it's wrong for parents to administer medication to children calculated to make life better for the parents at the cost of making life worse for their children (for example, by introducing difficulties sleeping, perpetual exhaustion, weight gain, reduced cognitive ability, depression -- all common and well-documented effects of psychotropic drugs).

As for not judging the situations of other families, consider this. What if you saw parents viciously assault their children? I bet you would be concerned about that. Administering drugs is a lesser violence and may not be illegal (although in some situations, it might be), but it's still something that we should be concerned about, not something that parents should be allowed to do without criticism.

I'm sure parents who beat their children believe they have very good reasons for doing so as well. Some of those parents might even be physicians. Physicians don't have a monopoly on ethics. The administration of psychotropic drugs should only be done with the consent of, and for the benefit of, the person who is taking the medication, not for the benefit of other parties (such as parents or "the family"), because otherwise it is a very significant violation of personal liberty to inject foreign brain-altering substances into a person's body (even if it's legal in the circumstances, it may be unethical).

Cathy you sound like you need some medication yourself with some of your bizzar rankings on here. How do you know that the children don't benefit? I don't beleive that children should be medicated unless it is an absolute necessity and there are cases where children do need it.

[justajane]

Cathy - What do you propose then if the child is physically or emotionally hurting other members of the family? What about the well being of the other children in the household? What if this hard line you take means that more children will be put in institutional environments or isolated in the house for the safety of the rest of the family? Isn't that even worse for a child?

I see your point, but you seem to only see the side of the medicated child and not that of the parents or the other children in the house.

You take a hard line on this, but life is all about shades of gray. It reminds me of when extreme pro-animal people champion the rights of the animal to the extent that they forbid declawing or spaying/neutering. In this case, the perfect is the enemy of the good, since if you forbid potential pet owners from doing some things that make their lives easier, they are likely not to adopt at all. This means that more pets will have to be euthanized, since they can't find homes for them.

Note - I am NOT comparing children to animals - merely comparing two instances when an ideal could actually be counter-productive.

[Cathy]

Cathy you sound like you need some medication yourself with some of your bizzar rankings on here. How do you know that the children don't benefit?

If you had read my post, and in particular the first sentence thereof, you would know that I expressed no opinion on whether any given child benefits from any given psychotropic drug, or whether any particular prescription is written for the purpose of benefiting the child rather than the parent. The very first sentence of my post says that "[administering drugs] might be done for the benefit of the parents" (emphasis added), and the post then goes on to say that in that situation, "it may be unethical". The post does not say that that situation is common. (It might be common, but my post did not express any view on that or make any claims about it.) The post does not even say that it's always unethical in that situation.

Choosing to ignore what a post actually says and instead responding with non-sequitur messages and the occasional insult is a common way that people handle seeing an opinion that challenges their beliefs. However, it's not conducive to growing and learning new things. I would encourage you to try a more constructive approach the next time you see something you don't agree with -- perhaps starting by reading it closely (and charitably), so you know what it actually says.

The particular insult you chose -- that I should be medicated because of my opinion -- is especially interesting because, as you no doubt know, psychiatry has a long and sordid history of being a tool used by the state to suppress speech, in particular in Soviet Russia (although by no means limited thereto). That history is all the more reason we should exercise caution in this area. In the United States, Canada, and other western countries, people are allowed to have differing opinions without being the subject of corrective state power to bring them into line -- whether clothed as psychiatry or otherwise. Your implicit suggestion that the content of speech should be regulated through a system of medication is a very frightening and extreme view, and one to which I cannot subscribe.

[KBecks2]

My son takes very expensive adhd meds.  I did not want to, but we decided to do a trial and it helped him at school.  So now he takes daily meds and this is so he can fit in and function better at public school.

The adhd medicine is a stimulant form that wears off through his system.
He takes it 7 days a week.  Our son is still himself on the meds.  It was a very difficult decision and I will live with that choice.  If my son requests to change it, we will explore that together.

Leave me and my family alone.

[La Bibliotecaria Feroz]

Yes, there is a line when you would judge other families, and physical abuse and neglect are obviously over that line. But there is a VAST gray area where decisions are complicated. I know that the latest research says that it's better to let a fever burn than to medicate. Am I a bad mom if I give a kid who a 101 degree fever some Tylenol because it's night time and he's already been awake twice and we all need sleep? A single parent of three children might have a lower threshold for medication than a stay-at-home parent with only one child to tend to. Life is messy and parenting is not a contest.

[jba302]

Louis CK has a great bit about this. Mom in a supermarket about to strangle her child who's just sitting there politely, because you didn't see the 12 hours of the kid being an absolute shit.

Our younger one is pretty significantly ADHD. Obnoxiously so most of the time, though we handle it pretty well without meds. I have absolutely thought "holy shit I want to kill you right now" for what would be zero discernable reason to an outside observer.

Maybe it was excessive, and maybe that lady picked the pill over murder. :)

[Cpa Cat]

When my stepbrother was young (starting at around age 6-7), he went on ADHD meds. The hyperactivity was total insanity. He was completely non-functional when off his meds. He was not able to learn, have conversations, make friends, or really truly "play" like a normal child (because all play turned into craziness). His meds helped, although the dosage would make him quite sleepy for some of the day.

No one felt great about drugging him up.

He stopped needing the meds after puberty. People who know him now would be shocked to find out that he had been on medication as a child. I know members of our family have wondered about it - it's like they rewrite what we lived because they don't believe problems as extreme as his could simply be outgrown.

I remember once being left to babysit him for the day (he was 8 years younger than me). I was supposed to give him his pill with breakfast, but when I went to give it to him, he told me he had already taken it (not true). Later, he had a temper tantrum and I had to barricade myself in my bedroom until he physically wore himself down.

I didn't have the door blocked for my convenience.

[Janie]

Judith Warner's book We've Got Issues is interesting reading on this. She set out to write the book with a bias that children were being overmedicated, but changed her mind over the course or researching/writing it. It's a worthwhile read.

ETA: It seems to me that, in general, there's a lot of overlap between benefit to child and family when disorders are successfully treated (whether that treatment is psycho-social or medical). It's not like a child is better off (socially, academically, or otherwise) when problems are left unchecked. 

[Blonde Lawyer]

I didn't get my adhd diagnosed until I was a 29 year old lawyer.  I really wish I had been on medication through high school, college and law school.  I did well but it was a huge struggle.  I would have done so much better with much less pain if I had just had my condition treated.  My friends like me better medicated and my marriage is better medicated.  I'm actually afraid if we ever decide to have kids about the time I would have to spend without my medication.  My brain doesn't function correctly and with the medication it does.  It is really hard to describe.  Withholding medication from children who need it is not the right answer either.

(I also use diet solutions and other behavioral techniques.  I'm not just all pharma for any of my conditions.)

[Cathy]

...I didn't get my adhd diagnosed until I was a 29 year old lawyer....

That reminds me of one of my favourite cases, Gichuru v. The Law Society of British Columbia (No. 4), 2009 BCHRT 360 (and the many other opinions related to this litigation). In Canada, the legal profession (including admission to the bar) is regulated by agencies known as "law societies", which are independent of the courts (unlike in the US).

This litigation concerns a question asked by the Law Society of BC on various of its admissions forms, namely asking whether the lawyer or prospective lawyer, has ever been treated for certain mental illnesses, regardless of how far it was in the past.

As the opinion discloses, if you answered "yes" to this question, the Law Society would treat you in a fairly ridiculous fashion, including requiring you to waive all medical confidentiality and submit to treatment, at your expense, by an appointed physician, even if the condition was clearly irrelevant to the practice of law. And the best part was that this regime continued indefinitely, even after the condition was under control, and even if it was always under control before ever dealing with the Law Society. There was also a continuing obligation to disclose such conditions.

The complainant Mr. Gichuru was a victim of this Law Society regime. In the case, he argued that the question was discriminatory on the basis of disability, and was unlawful. According to Mr. Gichuru, no lawyers were interested in representing him because litigating against the Law Society was a "black mark" that would ruin one's reputation in the legal community. Thus, he represented himself.

The Law Society advanced a spirited and aggressive defence to the claims. Their main argument was that the investigation of mental illness promoted the protection of the public and was justified by the Law Society's regulatory duties. But they really didn't want to reach the merits. They spent many years of litigation seeking discovery of all of Mr. Gichuru's medical records, or alternatively dismissal of the action if he declined to provide them. Mr. Gichuru's position was that the medical records were utterly irrelevant to the case, because none of his arguments turned on the details of his condition. On several separate occasions, the lower tribunal ordered disclosure of the records, but Mr. Gichuru was able to get it overturned each time on appeal. He never disclosed the records.

Eventually, in published opinion #4 (linked to above), the tribunal found in favour of Mr. Gichuru on all liability issues, finding, in a 153 page opinion discussing and rejecting a staggering array of arguments advanced by the Law Society, that the Law Society's question and procedures were discriminatory and illegal. You can get the impression from the opinion that it was an incredibly difficult case to win, which is why I think Mr. Gichuru is probably one of the most hardcore self-represented litigants I've come across in reading court opinions.

[MandalayVA]

We have a family rule for our children. Hugs not drugs. This served us well when they were teething. It's all to easy these days to load them up with Pamol and Bongella then send them to bed. Instead we spend time with them, even if it means sharing the bed all night. Because like wow that's such a hard thing to do.

Now a handful of times the pain was too much for them, and we would use either of the options, but it felt right knowing we had tried the alternative.

I'm not a parent but I have to admit that I'm uncomfortable with this.  Yes, psychotropic drugs for kids are handed out a little too freely, but to withhold pain medication is an entirely different matter.  Also, it's better to give pain medication before the pain becomes unbearable as it's more effective.  I'm not judging, it's my own thing.

[Blonde Lawyer]

Cathy,

I wrote a paper in law school that bars that required disclosure of all therapy or medications for "mental" conditions were actually creating more dangerous practicing environments as the potential lawyer or lawyer with an untreated condition (so he/she doesn't have to disclose it) is far more likely to harm a client than the lawyer that is properly treated by a physician.

This applies to many professions too.

[sheepstache]

We have a family rule for our children. Hugs not drugs. This served us well when they were teething. It's all to easy these days to load them up with Pamol and Bongella then send them to bed. Instead we spend time with them, even if it means sharing the bed all night. Because like wow that's such a hard thing to do.

Now a handful of times the pain was too much for them, and we would use either of the options, but it felt right knowing we had tried the alternative.

I'm not a parent but I have to admit that I'm uncomfortable with this.  Yes, psychotropic drugs for kids are handed out a little too freely, but to withhold pain medication is an entirely different matter.  Also, it's better to give pain medication before the pain becomes unbearable as it's more effective.  I'm not judging, it's my own thing.

I'm not a parent either but I'm surprised to learn painkillers for teething are common?

[Le Poisson]

If a kid is having a hard day, his/her  recourse is to act out, which only makes their day worse.

If an adult is having a bad day, they can have a drink, go to bed, take a walk, etc. etc.

Sadly, a kid has to keep shopping as long as they are being dragged around by Mom. Mom on the other hand goes home when she's tired. If a kid gets tired of homework, they have to keep staring at the page until its done. If Dad gets tired of paperwork, he can turn on the TV for an hour and do the rest in the morning.

If we let our kids do what they need to in order to deal with emotions, stress, etc. we might find less drugs needed. If less kids learned to deal with life by taking pills, fewer adults might be dealing with life the same way.

OTOH, our country neighbours were mostly drug free - they put their kids to sleep with a shot of whiskey. Rubbed it on the gums for teething, used brandy for a warmup when they went to milk the cows...

[enigmaT120]

I'm not a parent either but I'm surprised to learn painkillers for teething are common?

Teething doesn't hurt that much.  Or am I the only one who remembers his wisdom teeth coming in in my 20s?  It's mostly irritating.

[Le Poisson]

I'm not a parent either but I'm surprised to learn painkillers for teething are common?

Teething doesn't hurt that much.  Or am I the only one who remembers his wisdom teeth coming in in my 20s?  It's mostly irritating.

Depends on the kid. Some have a mild fever and little more. For others its a constant problem for days on end.

[Taran Wanderer]

We have some family friends with a grandson who was diagnosed ADHD.  Long ago, I watched him for a weekend so he wouldn't be home alone.  He was 12 or so, I was 18.  The first day, I made sure he took his Ritalin.  The second day, I took him on a 15 mile mountain bike ride.  Guess what - no more Ritalin needed!  He was the nicest kid after that mountain bike ride.

That's just one anecdote, or course, but it makes me wonder:  How many of these kids just need to go wear themselves out with a little exercise?

[gooki]

I'm not a parent but I have to admit that I'm uncomfortable with this.  Yes, psychotropic drugs for kids are handed out a little too freely, but to withhold pain medication is an entirely different matter.  Also, it's better to give pain medication before the pain becomes unbearable as it's more effective.  I'm not judging, it's my own thing.

Thanks for taking the time to reply. When you can solve the problem, by distracting the child by comforting them, surely that is better than administering drugs?

I'd do the same if my kid stubs their toe, yes it fucking hurts, but give them a cuddle put a plaster on it and they will have forgotten all about it in 10 minutes.

Depends on the kid. Some have a mild fever and little more. For others its a constant problem for days on end.

And the pain seems to manifest most at night when the body is growing. Which can be inconvienent for parents.

[justajane]

Regarding pain medications, I give them to my kids when they look like they are in pain - usually from a fever. Why? Because I give them to myself when I hurt. Why wouldn't I do the same for my kids? You don't give them because they cure anything; you give them to alleviate suffering.

I don't see why judicious use of analgesics is a problem. And yes, I have given them to my infant who is clearly hurting from teething.

I also give allergy medications in the spring and fall to one of my sons who always looks absolutely miserable rubbing his eyes.

[MandalayVA]

Teething doesn't hurt that much.  Or am I the only one who remembers his wisdom teeth coming in in my 20s?  It's mostly irritating.

You got off light.  When mine came in I was in so much pain I actually contemplated suicide because my sadistic dentist refused to prescribe me painkillers.  My only recourse was massive amounts of alcohol until I found a new dentist who would prescribe me.  It's been close to thirty years and I still remember that hell.

[enigmaT120]

You got off light.  When mine came in I was in so much pain I actually contemplated suicide because my sadistic dentist refused to prescribe me painkillers.  My only recourse was massive amounts of alcohol until I found a new dentist who would prescribe me.  It's been close to thirty years and I still remember that hell.

Oh.  I didn't realize it could vary that much.