Friday, March 23, 2007

Should we medicate children?

A troubling story is breaking in the news, about a 4-year-old girl named Rebecca Riley. Rebecca died Dec. 14th, of an over dose of prescription medication. Her parents are being held on charges that they deliberately over medicated Rebecca. The girl, had reportedly been having troubles for a long time, and a number of people around her were concerned, but none of them took enough action to protect her. In the months leading up to her death, she was described by a school nurse as being as floppy as a toy doll. Her mother, Carolyn Riley, kept coming up with reasons that her daughter needed medication, her pharmacist has reported.

While the death in itself is sad. It brings into question the medicating of such young children at all. How can it be known at such a young age, if they are in need of medication, or if they may just be developing at a different pace than their peers. The two fold trap I see for medicating children, is that parents will choose medication as an easy way to handle children they don't have time for. A bigger threat that I see, is what do the terms of mental illness mean at such a young age. If you child is struggling in school, and not bringing home the grades that would make you proud, do they need medication to be a better student. Will parents be giving their children drugs, because they think that if they are not a straight A student, something is wrong with them. The long term question, is that we do not know that long term effects of giving children, in some cases medications that are designed for adults. We do not know how it may adversely effect their developing bodies and brains.

According to the medical examiner, when Rebecca died, the following drugs were found in her system: Clonidine, a blood pressure medication used for ADHD; Depakote, anti-seizure / Bi-polar medication; a cough suppressant and an anti-histamine. The medical examiner said that the amount of Clonidine alone, was enough to be fatal. The two name brand drugs, are approved for adult use, but are often prescribed to children.

Rebecca's parents are defending themselves, saying that they were only following the doctors orders. They told police that Rebecca had been diagnosed with ADHD when she was 2 1/2 years old, and the doctor told her parents to give her the same medication that her older brother and sister. School officials and teachers claim to never have seen behavior that would indicate that the little girl had any of the medical problems her parents are claiming.

How does a child as young as 2 1/2 years old get labeled as being mentally unsound, and in need of medication? The vast majority of the young children I have known have had problems of an attention deficit, but they learn focus as they get older. How much are we medicating children for problems that either don't need to be dealt with, as they will naturally digress, or simple therapy or education could solve?

Prosecutors are claiming that the parents used the medication as a way to control Rebeca, and are charging them with murder for her death. The parents are pointing the finger at their doctor, Dr. Kayoko Kifuji, the doctor claims that Rebecca was diagnosed with ADHD based on family history, description of behaviors from Mrs. Riley and a brief office visit. The family doctor, her license has been suspended pending an investigation, told police that she had become alarmed when Mrs. Riley told her she was increasing Rebecca's dose from 2 tablets to 2 1/2. Kifuji, says that she warned Rebecca's mother that a dose that high could kill her.

According to people who saw the children in the months before Rebecca's death, they all looked listless. The day care that Rebecca stayed at called Mrs. Riley a number of times with concerns about the young girls health, her mother told them Rebecca was tired from not sleeping well.

The lawyer for the family is claiming that they are victims of the doctor, and the system, saying that they trust the advice of the doctor, looking up to them as god. Both the parents were un-employed, and had their own mental health issues. Her father Micheal Riley is awaiting trial on charges of sexually molesting a step-daughter in 2005. Her mother according to reports suffered from depression and anxiety.

While the family is claiming that the doctor prescribed to large a dose for Rebecca, the pharmacy records are showing a different story. In the last year of Rebecca's life, according to the pharmacist, the family was able to get 200 pills more than they should have. Mrs. Riley one time said the pills were lost, the next she said that water had gotten in the bottle and they were ruined. After a few incidents like this the doctor cut the amount to be dispersed from 30 day refills, to 10 day refills. On Aug 16th, Mrs. Riley filed an order for a 10 day refill, even though she had gotten another 10 day refill the day before. The lawyer for the family asserts that some of the pills may have been lost while cutting them in half, or given to Rebecca's siblings.

The most damning evidence may come from those who saw the girl in the days before she died. Rebecca's uncle James McGonnell, who lived with the Riley's said that the children were put to bed sometimes as early as 5 p.m. McGonnell, said that often Rebecca would sleep through the day, waking only to eat. He further supports the claims by the prosecution that pills were given to the children when they were "acting up". The last days of her life, Rebecca spent wondering around the house, sick and disoriented, her parents have said it was just a cold.

Kelly Williams, McGonnell's girlfriend who also lived in the house, told police that the night before Rebecca died, she looked pale and out of it. When the young child knocked on her parents door and called for her mommy, Mr. Riley yelled through a crack in the door for her to go back to her room. McGonnell found his niece later that night, struggling for breath, he wiped the vomit from her mouth and kicked in her parents door. He says he told her parents that they needed to take her to the hospital. Instead her mother gave her more medication.

Rebecca was found dead, on a pile clothes, magazines and a stuffed bear, on her parents' bedroom floor.

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