Kudos to Art Levine for Exposing Government Complicity in Illegal Psychiatric Drugging of Children

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In a well-researched, comprehensive article in today’s Huffington Post, Art Levine has brought to the attention of the mainstream media the government’s complicity in the illegal psychiatric drugging of poor children, especially foster children, through Medicaid.  The article, Feds Pay for Drug Fraud: 92 Percent of Foster Care, Poor Kids Prescribed Antipsychotics Get Them for Unaccepted Uses is the only mainstream article I know about that has really pressed the federal government over its refusal to enforce Medicaid’s coverage restrictions to “medically accepted indications.” In a nutshell, Medicaid (and Medicare) only allow reimbursement for drugs prescribed for uses approved by the Food and Drug Administration (FDA) or supported by one of three specified drug references called “compendia.”  Another way to say it is that off-label coverage is restricted to uses supported by at least one of the compendia.

Discussing a recent Inspector General’s Report,  Mr. Levine writes:

“Perhaps even more damning, the report found, 92 percent of all kids on Medicaid receiving antipsychotics don’t have any of the limited ‘medically accepted pediatric conditions’ supposedly justifying their use. These ‘accepted conditions’ include the authority to use antipsychotics even for autistic children as young as 5 for such dubious FDA-approved conditions as ‘irritability.’

“So just how far outside the bounds of sensible prescribing must a doctor be that government approval to provide antipsychotics to a 5-year-old child is somehow considered too limiting? Yet that’s precisely the sort of free-fire-zone prescribing underway now for 92 percent of those kids receiving antipsychotics in foster care and the broader Medicaid program.”

The other side of the coin is the use of neuroleptics (I don’t call them “antipsychotics”) to render nursing home patients incapable of putting up much of a fuss (See Key Unmet Needs Associated with Behavior Problems in Dementia Patients in today’s MIA news).  Medicare coverage has the same restriction to medically accepted indications and Mr. Levine notes:

“‘Prevention of [improper] payment [is] beyond our statutory authority,’ HHS’s Center for Medicare and Medicaid Services (CMS) insisted in response to a related 2011 Inspector General report about massive overprescribing in nursing homes.”

In other words, federal officials in charge of Medicaid and Medicare have a formal policy of turning a blind eye to the illegal payment of these prescriptions.

Part of the problem, of course, is that federal Medicaid officials still insist that they don’t have the legal authority to stop paying for worthless and dangerous drug uses; that’s in apparent opposition to a series of federal court rulings and Justice Department fraud lawsuits concluding, as in a $2.3-billion settlement with Pfizer, that the federal government has been defrauded when it’s asked to pay for drug “uses that were not medically accepted indications and therefore not covered by those programs.”

The article goes into some detail about the various fraudulent schemes employed by the drug companies, aided and abetted by prominent psychiatrists, known as “Key Opinion Leaders,” to promote the harmful drugging of children and the mostly sham programs pretending to address the problem.   The realization that government officials are unwilling or unable to stand up to the drug companies and doctors is a big reason why the Law Project for Psychiatric Rights (PsychRights®) was founded; to mount a strategic litigation campaign against forced drugging (the drugging of children and the elderly is almost always forced).

The article includes links to PsychRights’ Medicaid Fraud Initiative Against Psychiatric Drugging of Children & Youth and Briefing Paper: The Financial And Societal Costs Of Medicating America’s Foster Children: A Proposed Solution.

The former involves bringing False Claims Act (whistle blower) cases against doctors and pharmacies as a way to curb the practice and the latter suggests the government take the following three steps:

 1. Announce that outpatient psychotropic drug prescriptions for use in children and youth that are not for medically accepted indications are not covered under Medicaid, and will no longer be reimbursed, except;

2. Where abrupt withdrawal from drugs that are not for medically accepted indications can cause serious problems, then allow reimbursement for responsible tapering, and;

3. Grant amnesty from False Claims Act liability for all past prescriptions that are not for medically accepted indications.

In the absence of government enforcement of the Medicaid and Medicare coverage restriction to medically accepted indications, PsychRights is looking for people to pursue whistle blower cases to curb these illegal, harmful practices.

PsychRights also urges people to press  government officials to enforce Medicaid’s coverage restriction to medically accepted indications.

Again, kudos to Art Levine for having the courage to speak truth to power.  I urge everyone to read it and share it, especially with people who are not knowledgeable about this horrific abuse of America’s poor children and youth.

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Videos of Jim Gottstein on the topic of the psychiatric drugging of children & the elderly:

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Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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Jim Gottstein, JD
Law, Alternatives and Change: Law, Alternatives and Change: A Harvard-educated lawyer and long time activist for change in the mental health system writes about law as it relates to psychiatric rights and fostering truly helpful, non-coercive alternatives to the current system. Jim's book, The Zyprexa Papers, chronicles the dramatic events surrounding his subpoenaing and releasing secret, damning Eli Lilly documents and surviving the resulting legal onslaught by Lilly, as well as his battles fighting the forced drugging of Bill Bigley for whose case the documents were subpoenaed.

14 COMMENTS

      • Crimes against humanity, indeed.

        The late, unlamented Soviet Union abused psychiatry when it came to dissidents. Speaking truth to power carried a well-understood risk of being labeled “crazy” or antisocial, and forcefully “medicated” with neurotoxic drugs. What we do in this country is much, much worse. We forcefully drug the most defenseless and vulnerable members of our society, our children. At least the dissidents had some choice in the matter. Not much of a choice (to stay silent), but some measure of choice. These children have no choice at all. For shame.

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        • Before there was government complicity in illegal psychiatric drugging of children there was and still is government complicity in illegal medical drugging of children . And all the rest of us for that matter. There is precedent , and that is one factor in what emboldens psychiatry.
          http://www.whale.to/b/blaylock.html

          Guaranteed if there were 100 Robert W’s to investigate all the misery and death causing pseudo science and criminality within APA Psychiatry , AMA Modern Medicine , ADA Dentistry , the Pharmaceutical Cartel ,and Monsanto , with all their government and other connections there still would not be enough Robert W’s to get to the bottom of the sh-t pile .

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  1. Thanks Jim! One thing that’s encouraging is that all of the comments (at least so far) are supportive. In the comments section, people also share stories of their own experiences of psychiatric torture as children. The commenters are not only agreeing with the article but criticizing the entire psychiatric system. I don’t think I’ve ever seen such an enlightened string of comments about psychiatry anywhere, even here on MIA where we sometimes feel we are preaching to the choir.

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    • Wow, Chaya. I kind of skimmed the HuffPost article, but didn’t think to look at the comments. It is very unusual for HuffPost to publish anything very critical of psychiatry (though they do occasionally print articles by Bruce Levine and Peter Breggin). I think it may influence them to publish more articles like this if their readers are supportive as you describe.

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  2. I took a look at the comments, and what occurs to me is that the public gets much more upset about the drugging of children than of adults. When I was organizing the ban on shock treatment many years ago, I noticed that many people who would otherwise defend shock were outraged at the idea that I was given it at age six. Psychiatric abuse of children is an issue that resonates very deeply with people. Few will defend it, even if they otherwise practice the religion of psychiatry.

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    • Very true, Ted, and good point. Though I do know some otherwise intelligent and kind people that seem to think it’s good to give kids psych drugs if it improves their performance in school, hence raising their self esteem or something. And gosh, if so few people were for it, it doesn’t seem like we could possibly have the numbers of kids on them that we do. It is pretty cool to have a unanimous comment section on HuffPo, and not only that, they are almost all clearly anti-psychiatry as a whole. None of them mention a single thing about the possibility of psych drugs as “preventative treatment for developing mental disorders later on” or even any party lines like, “meds can be good for some people but they are over prescribed.” Nope, not one single BS line in the entire comment section. This is a victory!

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  3. Drug the youngest so they may become life long drug dependent slaves. Drug the elders to the gills so they can’t warn those younger of whats comin and what they’ve seen in their lives. It’s easier to warehouse the elders in quantity and smaller space if they are kept quiet and seated, besides think of added profits from the extortion potentials. Keep the rest rousted about and impoverished concerned about their children and elders and fearful for themselves while everything is stolen by individuals that should be specifically named with addresses and phone numbers etc ,Oligarchs especially.Their flunkies next . And how they interact . Some how they must brought to justice or justice brought to them.

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  4. I have a problem with this strategy of nibbling away at the massive overselling of ‘anti-psychotics’ by going for the Achilles heel of the industry’s practice: off label drugging of children and the elderly. My loved who is forcibly medicated with neuroptics is not helped one whit by nibbling away at the problem of over drugging. ‘You can drug those people who are really really sick but not these people who ate merely inconvenient.

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    • I was almost 18 (1964-65) when I was forcibly taken into an institution for the 3rd time . It was unjust and built on false assumptions , no one would believe me and yet my parents meaning well, of course, went along with the psychiatrists recommendations. He was a doctor after all and doctors are educated and of course doctors are always right . I was to get 15 bilateral electric shook treatments , I just wanted to get out of there.
      While the decision was being made behind my back unknown to me. I saw a 9 or 10 year old little boy that was in the same psych unit as I was in , he was the youngest child I ever saw in a psych hospital among older people. I saw him a few times with an 18 year old man before I realized he was being molested. I threw the 18 year old to the floor and told him to leave the kid alone . There was no protection for this child and sadly I realized the 10 year was just going along with this older pervert and the staff was unable to protect him. 15 shock treatments wasn’t enough to make me forget that poor kid at Jackson Park Memorial Hospital in Florida back then. Kids can’t defend themselves against adults . Someones got to do it. Don’t you think?

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  5. Thank you Jim Gottstein for this article, it is indeed worse than worst that society drugs kids who already have suffered enough. It is nothing but a big shame. So far the conditions in Sweden is not as horrible as in US due to drugs and kids, but as it seems it becomes more and more usual to prescribe drugs to children and young people – even when it is undoubtable that it is the context which is “crazy” and not the young person. I admire the work you do, and please continue!!!

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