Down the Hatch

The Texas Attorney General's Office says a drugmaker lied in order to push an antipsychotic on foster children. So why are kids as young as three still taking the drug?

Down the Hatch

In 1993, Johnson & Johnson owned schizophrenia.

That multimillion segment of the antipsychotic market had long been an untapped income source, populated by old-school generics that came with their fair share of side effects.

But now J&J, through its subsidiary Janssen Pharmaceuticals, blew the doors off the market with its risperidone tablet, available in a rainbow of colors and sold under the name Risperdal.

A week before she went into foster care, Rachel Harrison looked healthy.
Courtesy of David and Christina Harrison
A week before she went into foster care, Rachel Harrison looked healthy.
Rachel's parents say she appeared fatigued and ill during visitations while in CPS custody.
Courtesy of David and Christina Harrison
Rachel's parents say she appeared fatigued and ill during visitations while in CPS custody.
Click the image to view information regarding Psychotropic Medication in Texas Foster Care for 2011.
Click the image to view information regarding Psychotropic Medication in Texas Foster Care for 2011.

Quite simply, J&J's competitors could suck it. Astra Merck had expected to launch its counterpart nine to 12 months after Risperdal, but intelligence gathered by J&J spooks revealed that the company had voluntarily withdrawn its FDA application. And Eli Lily's competing pill was still years away from approval.

Of course, one of the biggest problems with schizophrenia, besides its soul-crushing dreadfulness and tendency to tear families apart, was that there was only so much of it to go around. Eventually, Janssen would have to expand Risperdal's usage and penetrate new markets. Bipolar. Dementia. Attention-deficit. And, just for the heck of it, stuttering.

Old people and kids were virgin territory; hopefully there were enough psychiatrists out there to find enough things wrong with them that could be treated by a little Risperdal. The problem was, the FDA had denied Janssen's application for pediatric use, which meant that — even though the drug could be prescribed off-label — it couldn't legally be marketed for anything other than schizophrenia in adults.

Janssen got around that prohibition by simply ignoring it and getting down to the business of figuring out how to infiltrate a state's Medicaid formulary and position Risperdal as the preferred drug for a variety of conditions. And the best way to do that was to get state mental health experts and influential doctors at universities to spread the gospel. These were the people Big Pharma calls KOLs — key opinion leaders, experts in their fields, whose casual approach to integrity and love of all-expense-paid junkets in Hawaii helped push product.

With its huge Medicaid population, encompassing prisons, psychiatric hospitals and foster care, Texas was the best state for this. Once a Risperdal-friendly system was installed in Texas, it could be exported to other states.

So Janssen reps went to Texas and trolled for whores. They came out in spades; from the state Department of Mental Health and Mental Retardation; from the University of Texas system; from state chapters of national mental health advocacy groups. They all helped Janssen market off-label Risperdal use in children by, in some cases, downplaying the side effects of severe weight gain, diabetes, tremors and the growth of (sometimes lactating) breasts in males.

In 2003, when the whistle was blown and the connection between the experts and the drug companies was revealed, state attorneys general licked their lips in anticipation of filing fraud suits to recover Medicaid costs.

The Texas Attorney General's Office filed its suit in 2004, alleging that Janssen's marketing suppressed information about Risperdal's side effects, manipulated or concealed clinical trial results and created "the false impression that valid and well-supported scientific evidence" supported the prescribing of the drug to children. In its goal to create "noise" in the market, the lawsuit states, Janssen seeded medical journals with ghostwritten studies that were essentially advertisements masquerading as legitimate studies.

But the Attorney General's lawsuit, set for January 9, is about money — about recovering millions the state had spent paying for Risperdal. It is not about the well-being of children in state care, who are still prescribed Risperdal and other antipsychotics. Those kids are other agencies' problems.

So that's how Rachel Harrison, a girl who was born three years after the state Attorney General filed suit, and who wound up in foster care in 2010, found herself swallowing four tablets of risperidone a day, with no clear diagnosis.

Her foster mother had initially complained of Rachel being hyperactive and uncooperative. One doctor thought she might have had a mood disorder. Whatever the case, the easiest thing to do to stabilize this kid in the care of one governmental department was to give her a heavy dosage of a powerful antipsychotic that another department was suing over, and to have taxpayers foot the bill.

Maybe it was the combination of all the other drugs Rachel was on while she was in foster care, but the risperidone didn't cause her to balloon out; she actually lost weight. Her hair became wispy and started falling out. Her eyes retreated into what now looked like a freakishly enormous head. One photo her mother was able to sneak during a visitation — before her cell phone was confiscated — looks like it should be the "before" picture, not the picture of a kid after she's in the state's care.

While there are certainly foster children, and others on Medicaid, who have severe enough conditions to warrant the use of antipsychotics, the remarkable thing is that some of the "key opinion leaders" exposed years ago are still crafting the guidelines for these meds in foster care, and some of the ghostwritten journal articles cited in the Attorney General's lawsuit are still being used to justify the drugs' continued usage.

Before any major studies got off the ground, Janssen had already created Risperdal's advertising platform — "One Complete Antipsychotic" — and set its sights on corralling key opinion leaders who could deliver the message.

The company's 1993 Product Market Plan called for penetration of three customer segments: providers (prescribing physicians), KOLs who could "influence the politicians," and payors (government agencies). But first, the company had to, through the use of a comprehensive marketing campaign, "create a need and demand for new first-line antipsychotics" and then persuade everyone that Risperdal was the one drug to meet that need. (Risperdal's patent didn't expire until 2007.)

According to an expert witness report filed in the Texas AG's lawsuit, the push kicked off in earnest in 1995 with the establishment of what would come to be known as the Tri-University Guidelines. Janssen funded the research of three friendly physicians at Duke, Cornell and Columbia, with the understanding that they'd all agree that Risperdal was better than first-wave antipsychotics, according to an expert witness report commissioned by David Rothman, a Columbia University professor and psychologist. [See "Down the Hatch: The Rothman Report."]

To better proselytize their Risperdal-friendly findings — and to better line their pockets from the sale of publications and speaking engagements — the three professors incorporated Expert Knowledge Systems. The J&J-funded entity acted as a "strategic partnership with Janssen," according to a filing in the AG's lawsuit, whose mission was to build brand loyalty. Between grants, educational conferences and dissemination of publications, ESK accepted $942,000 from J&J.

Enter the Texas Medication ­Algorithm Project, or TMAP.

With the Tri-University Guidelines in place, Janssen now had to find key opinion leaders in order to move Risperdal to the top of the state's preferred-drug list. The idea was to claim Texas, and then export TMAP to as many other states as possible; ultimately, at least 16 states incorporated the project.

According to the Rothman report, some KOLs recruited for the job included Dr. Steven Shon, then the director of the Texas Department of Mental Health and Mental Retardation; Dr. Lynn Crismon of the University of Texas's College of Pharmacy; Drs. Alexander Miller and John Chiles of UT Health Science Center in San Antonio; and Joe Lovelace, then the head of the Texas chapter of the National Alliance on Mental Illness.

Janssen, of course, denies the Texas AG's claims. A company spokeswoman said she could not discuss details while the case was pending, but did state in an e-mail that "Janssen is prepared to vigorously defend itself against these claims. We are committed to ethical business practices, and have policies in place to ensure that our products are only promoted for their FDA-approved indication. If questions are raised about adherence to our marketing and promotion policies, we act quickly to investigate the situation and take appropriate disciplinary action."

Prior to TMAP, Medicaid guidelines called for doctors to prescribe generic, conventional antipsychotics; they couldn't touch the much more expensive second-generation drugs, called "atypicals," until two or three conventionals had failed.

The drug companies' hurdles, then, were to come up with solid arguments to move their atypicals to the front of the line, despite their cost and the lack of data showing they were any better than conventionals. They had to persuade KOLs that the exorbitant upfront cost would actually save money in the long run because of the atypicals' relative lack of side effects as compared to conventionals. Of course, there wasn't much unbiased data supporting that.

As Rothman — the Texas AG's expert witness — wrote, "From the very beginning of TMAP, its leaders gave only lip service to conflict of interest considerations, ignoring principles in their search for industry funds...J&J fingerprints were all over the TMAP algorithms."

In one example, Rothman pointed out how in 1996, TMAP positioned both atypicals like Risperdal and the generic conventionals at Stage One, meaning physicians would be able to pick either one as a first choice for patients. But after Dr. Steven Shon and his fellow KOLs accepted $300,000 from J&J and other companies in 1997, conventionals dropped to Stage Four in 1998.

By the time of Janssen's 1999 Tactical Plan, Risperdal was the most prescribed atypical antipsychotic, more than doubling projected sales for each year. (While it was the second-most prescribed atypical, Eli Lilly's Zyprexa actually generated a higher dollar amount because it was more expensive.)

Janssen also desperately wanted to corner the pediatric market. Although Risperdal was already being used off-label to treat children, the company didn't have enough data on pediatric safety and efficacy for FDA approval. When the company sought the pediatric nod in 1996, the FDA responded somewhat incredulously: "You never state for what child or adolescent psychiatric disorders Risperdal would be intended. Indeed, you acknowledge that you have not provided substantial evidence from adequate and well-controlled trials to support any pediatric indications nor developed a rationale to extend the results of studies conducted in adults to children. Your rationale...appears to be simply that, since Risperdal is being used in pediatric patients, this use should be acknowledged some way in labeling."

This was hardly a stumbling block; all Janssen had to do was not tell anyone about this denial and just buy favorable pediatric research and ghostwrite glowing articles.

The go-to man for psychiatric disorders in children was Harvard's Joseph Biederman, a man who would one day explain in a deposition that the only entity with a higher professional ranking than him at Harvard was God. (In 2010, Harvard disciplined Biederman and two other researchers for not disclosing $4.2 million they accepted from pharmaceutical companies between 2000 and 2007. The doctors wrote a letter of apology, explaining that they had "learned a great deal from this painful experience.")

The company built Biederman a research lab, the Johnson & Johnson Center for Pediatric Psychopathology, pledging annual funding of $500,000. According to the Rothman report, a J&J employee explained internally that the purpose of the Center was "to generate and disseminate data supporting the use of risperidone in this patient population." All Biederman had to do was churn out a bunch of our-drug-is-better-than-yours studies under his imprimatur, which would hopefully act like kryptonite on many a skeptical shrink.

It was a bean counter in Pennsylvania's Office of Inspector General, whose job was apparently to rubber-stamp portions of that state's TMAP clone, who blew the whistle.

In an essay, the investigator, Allen Jones, described TMAP thusly: "a Trojan horse embedded with the pharmaceutical industry's newest and most expensive mental health drugs. Through TMAP, the drug industry methodically compromised the decision making of elected and appointed public officials to gain access to captive populations of mentally ill individuals in prisons and state mental health hospitals."

Jones's allegations triggered an investigation into TMAP's reach into the foster care system by the Texas Health and Human Services Commission's Office of Inspector General and the Texas Comptroller's Office.

The latter turned up some weird stuff, like the case of a six-year-old who'd received 60 prescriptions (including antipsychotics and mood stabilizers) in the course of a year. The child was eventually admitted to a hospital emergency room and treated for psychotropic poisoning.

The comptroller's investigators were alarmed by the numbers they crunched for fiscal 2004: 6,913 foster children accounting for 65,469 prescriptions of antipsychotics. The average number of prescriptions for all psychotropic drugs (not just antipsychotics) for the 686 kids aged zero to four was 6.7. The number of Risperdal prescriptions alone was 23,812, which cost the state roughly $4.5 million.

Clearly, there was a problem. And clearly, something as important as vulnerable children treated with medication whose safety and efficacy were in question demanded a serious, thoughtful response.

What the children got were a set of guidelines, the Psychotropic Medication Utilization Parameters for Foster Children, developed in 2005 by some of the same people already outed as industry shills.

The parameters were overseen by some of the most important acronyms in state government: the Department of Family and Protective Services, the Department of State Health Services, and the Health and Human Services Commission.

They've been updated periodically, most recently in December 2010.

The acronyms involved have touted the parameters as being responsible for lowering the percentage of antipsychotics used in foster care. But among the more astounding things is that the parameters cite some of the same journal articles that the Rothman report exposed as ghostwritten and that two respected psychiatrists the Texas AG hired as expert witnesses in the Janssen lawsuit are critical of the parameters.

Dr. Robert Rosenheck, a professor of psychiatry at the Yale School of Medicine, wrote that "the review seems further unduly biased in favor of risperidone in particular."

The other expert witness, Dr. Bruce Perry, senior fellow of Houston's ChildTrauma Academy, and adjunct professor of psychiatry at Northwestern University, wrote that the group behind the parameters "should provide full disclosure regarding their current and past relationships with industry, including direct funds for consultation, speaking, and indirect funds to support 'education' or 'research.' This should also include the professional groups who are claiming to endorse this."

Besides that lack of financial disclosure, the parameters suffer from the inclusion of ghostwritten journal articles, something that a rash of lawsuits against drugmakers have shown is more common than originally thought.

In 2009, the Journal of the American Medical Association conducted a survey on the rates of ghostwriting in 630 articles published in six medical journals in 2008. The Journal published ghostwritten articles at a rate of 7.9 percent; the New England Journal of Medicine's rate was 10.9 percent.

As described in the AG's expert witness report, a company called Excerpta Medica was hired to draft some of Janssen's Risperdal articles.

In 2003, according to Rothman, Excerpta Medica issued "Risperidone Publication Program Status Reports," indicating that 30 of the 145 articles to be published had authors listed as "to be determined."

Rothman also examined what he considered a signature ghostwritten piece meant to boost Risperdal's pediatric profile; the study is included in the 2010 parameters.

Rothman cited a barrage of e-mails between Excerpta Medica and J&J in crafting the article. At one point, an Excerpta Medica employee wrote, "It would be very helpful to receive some guidance in relation to the flow, format and subject in this paper and whether you think this is too marketing oriented or not, in order to prepare a next draft. Besides that we would like [to] have some suggestions for external authors on this paper. Maybe [a] U.S. and a European KOL? Your input will be much appreciated.'"

The article eventually appeared in a 2007 volume of the European Journal of Child and Adolescent Psychiatry. For a lead author, J&J scored a heavy hitter: Dr. Peter Jensen, former associate director of child and adolescent research at the National Institute of Mental Health, and the founding director of the Center for the Advancement of Children's Mental Health at Columbia University. Now with the Mayo Clinic, Jensen declined to comment for this story.

While the article noted funding from J&J, as well as the fact that three of the authors were J&J employees, there was no conflict of interest statement and no disclosure of Excerpta Medica's involvement, Rothman wrote.

For another article, meant to tout Ris­perdal as a good treatment for acute mania, J&J and Excerpta Medica staffers met to hammer out the niggling details, like whose name would go on it. The "Publication kickoff meeting" notes state: "Lengthy discussion ensued around the importance of authorship from internal and external perspectives, and from clinical vs. commercial perspectives."

Perhaps a more malignant form of ghostwriting involved an article touting Risperdal's efficacy in children with below-average IQ: After reviewing Excerpta Medica's various drafts of the manuscript, Rothman wrote, "J&J conducted a separate review of the manuscript and made changes that would put Risperdal in a better light...In the abstract, for example, Pandina [a J&J employee] changed 'no negative effects' to 'positive effects.'"

Dr. Howard Brody, who heads the Institute for Medical Humanities at the University of Texas Medical Branch, has concerns about ghostwriting's contamination of medical literature. Brody studies conflicts of interest, which he explored in his 2007 book Hooked: Ethics, the Medical Profession, and the Pharmaceutical Industry.

In looking at the rise of atypical antipsychotics, Brody says, two major questions come to light: Are they overprescribed, and "the question of the impact this has on what's in the medical literature and whether...we're distorting the scientific base of medicine by ghostwritten articles, and articles that are deliberately spun in order to sell drugs rather than to present the dispassionate, scientific information. And of course, you could do a lot more damage with the latter than you can with just one physician prescribing, you know, for one group of patients."

When asked about the inclusion of ghostwritten articles in the 2010 parameters for antipsychotics in foster care, DFPS spokesman Patrick Crimmons explained in an e-mail, "We don't agree with that characterization — that it is a 'ghostwriting company.' It is a publishing company."

In 2009, State Rep. Sylvester Turner co-authored a bill calling for the prior authorization of any antipsychotic prescribed to children under age 11 who are enrolled in Medicaid.

The bill was DOA; a substitute measure calling for the Health and Human Services Commission to study the safety and appropriateness of antipsychotics for Medicaid children under 16 was passed in its place.

While it may be easy to criticize the acronym agencies for continuing to use potentially compromised doctors and data, it's another thing to be in the foster care trenches, treating children who can be in great physiological pain.

Just as the Texas Comptroller cherry­picked some truly outrageous instances of overmedication and departmental neglect in her report on antipsychotics in foster care, the commission found severe cases where nothing but antipsychotics seemed to work.

Take the case of a 20-month-old male whose mother reportedly used multiple drugs during pregnancy: He wouldn't stop banging his head and biting himself, had "an inability to soothe himself, and increased agitation with touch, making feeding, bathing, and diaper changes extremely difficult."

He couldn't be held, "as this will trigger crying episodes and repeated head banging and biting." Ultimately, a neurologist put him on a low dose of risperidone, which seemed to reduce the symptoms.

In perhaps a less compelling case, risperidone came to the rescue when a hyperactive and disruptive three-year-old girl didn't respond well to her daycare teacher sprinkling Dexedrine on her pudding. After risperidone, the girl "is now able to sit in groups," whereas before she would try to escape the classroom. "Several times she has managed to get out of the daycare, and was found outside near the street." (It is unclear whether the state commissioned another study to examine the mystery behind that particular daycare's apparently nonfunctioning doors or lack of a playground fence.)

Some physicians and mental health advocates saw Turner's bill as a medically risky governmental intrusion, another bureaucratic layer that might delay much-needed help.

Generally, the commission's study appears to have at least attempted a balanced, reasonable approach to examining the issue, with a goal of using the best science possible to determine if and when to use these kinds of drugs on such a young population.

That's why it's all the more frustrating that the study cites ghostwritten journal articles in its appendix, and holds up the conflict-of-interest-plagued parameters as an example of evidence-based policy. It's almost as if, six years after the Texas AG sued Janssen, the commission either wasn't aware of the evidence amassed in that lawsuit, or simply didn't care. (Unlike the parameters, the commission study at least attempted to identify the journal articles that were funded by drug companies.)

The commission found that, since 2005, "physicians have prescribed fewer psychoactive medications" to children in foster care. The study claimed that, from 2004 to 2009, "the percentage of youth in foster care receiving a psychoactive medication for 60 or more days decreased by more than a third, from 29.9 percent to 19.7 percent."

Recognizing a shortage of mental health experts in parts of the state, the commission called for the consideration of "consultation, including via telemedicine, for non-psychiatrists serving Medicaid youth with mental health disorders," as well as the consideration of wider integration of psychosocial services.

Importantly, but unsurprisingly, the commission distinguished three areas "in which there is little to no high-quality evidence on the use of antipsychotics": The use of multiple concurrent antipsychotic medications in youth; the use of any antipsychotic in children under three (with only "minimal evidence" for use in kids ages three to five); and the long-term effects (greater than three years) of any of the antipsychotics.

In her comments to a draft of the study, Dr. Regina Cavanaugh, president of the Texas Society of Child and Adolescent Psychiatry, saw Turner's proposal as just another barrier to treatment: "As the new president of TSCAP, it is with a sad heart that I tell you that I no longer provide care to foster care children," she wrote. "...I gave up seeing foster care children within 2 years, as I was unable to provide the quality of care I believed was necessary. Caseworkers withheld consent for antidepressants for children who were sexually abused and suffering with depression and PTSD, and not responding to months of therapy...The time needed to do prior authorizations, and the growing restrictive formulary were not conducive in my practice setting."

Dr. Debra Atkisson Kowalski, chair of the Texas Society of Psychiatric Physicians' Child and Adolescent Committee, wrote that "increasing administrative burdens upon physicians to provide care could directly result in less care being available."

Upon presenting his measure to the House Public Health Committee, Turner said, "This bill does not deny any medication to any kid...We are not saying a blanket 'no'" to any medication. He called it "not a red light, just a cautionary light."

Picking up on vehicle-related metaphors, Federation of Texas Psychiatry lobbyist Steve Bresnen told the Public Health Committee that he was part of the original legislation that spawned the parameters: "We built a car. We didn't throw a wrench into the works...I'm afraid this bill will throw a wrench into the works."

Bresnen felt great affinity for the movement behind the parameters, claiming, "I wrote that legislation spontaneously, sitting at my desk." He took great umbrage at a previous speaker, part of the Church of Scientology's "Citizens Commission on Human Rights," who supported Turner's measure, perhaps in no small part because Scientology abhors psychiatry and its attendant medications.

"I'm not going to have the people who wrote the 2005 legislation slimed without responding," Bresnen said, pointing out the speaker's Scientology ties.

Also on the record as opposing the bill were members of the Texas Pediatric Society, the National Alliance on Mental Illness, and Mental Health America of Texas, the last two organizations heavily funded by drug companies.

On hand to testify, should any of the legislators on the committee have questions about the Texas AG's lawsuit, and its uncovering of extensive conflicts of interest and ghostwriting, was Cynthia O'Keefe, deputy chief of the office's Civil Medicaid Fraud division. Strangely, there were no questions.

Dr. George Santos, of the Harris County Hospital District's management board, and a member of the Texas Society of Psychiatric Physicians, also opposed the bill, saying he was "always a little bit nervous about legislative intrusions into doctor-patient relationships."

Santos added that the state's mental health experts were also keeping abreast of "the peer-review journal articles" in order to continue providing the best care for children in Medicaid.

As Santos wrapped up, committee member Garnet Coleman thanked him and said, "I trust that you're going to continue, as you always have, to protect the integrity of the practice of psychiatry."

"You wouldn't let me do anything else," Santos said.

"Integrity" probably wouldn't be the first adjective that Rachel Harrison's family would use to describe what happened to her.

Rachel appears to have wound up in foster care after her father had a falling-out with an extended family member, who subsequently called CPS with an allegation that Rachel's mother had tested positive for marijuana while she was pregnant. While there were no signs of abuse or neglect, Rachel's parents at one point tested positive for cocaine. This was enough to remove Rachel from the home.

After Harris County District Court Associate Judge Stephen Newhouse found there was absolutely no evidence of abuse or neglect, and after expressing his bewilderment over why she was put on an antipsychotic in the first place, he returned Rachel to her family last May, 11 months after the state removed her.

Although the judge ordered DFPS to turn over Rachel's medical records to her family, DFPS has maintained they are departmental property and have not followed the judge's orders. In the end, Rachel's parents got the documents from the County Attorney. To this day, they say, they don't know the extent of the drugs she may have been prescribed. (Rachel's story was first reported by KRIV investigative reporter Randy Wallace, whose reports may have had a lot to do with why CPS ultimately changed its mind about terminating parental rights.)

The safety apparatus suggested within the parameters somehow failed to notice that Rachel was prescribed twice the state's recommended dosage of risperidone, without even having a clear diagnosis. However, it may not have been a big deal, because the notes of one of Rachel's doctor's reflect that the medication risks were "discussed with patient," that the patient was "counseled on recognizing medication side effects and adverse reactions" and that the patient "voiced understanding."

In the beginning, David and Christina Harrison say, they weren't even told their daughter was taking risperidone. And an e-mail one of Rachel's CPS caseworkers accidentally copied them on explains how the agency didn't want to disclose the extent of her medication: "He asked why was he not notified about Rachel being on medicine," the woman wrote. "I had another call come in and I stated to hold. When I retrieved the call I stated to him I was uncomfortable and wanted to speak with him in the presence of my attorney only."

Rachel's parents say that she was fatigued during visitations and alternated between vomiting and drooling. They also say she would mimic her various doctors by scribbling on paper and handing it over, as if it were a prescription.

"Physically, she came around quickly," David says of Rachel's return. "You know, four-year-olds, they're built like steel. They bounce back — physically — very well. Mentally, socially, she wasn't the same Rachel." He says it took about five months before she started "being Rachel again." ("Being Rachel" includes riding her pink bicycle, begging her grandmother for just one more popsicle and ordering any visitor to the home to listen to her strum endlessly on a guitar.)

During that time, which the parents refer to as Rachel's detox or rehab period, Rachel would sometimes grow anxious, and her mother says she eventually turned to the power of the placebo: She gave Rachel SweeTarts that were the same color as the risperidone.

While Rachel was gone, her parents sat through court-ordered parenting classes. Considering the circumstances, Christina Harrison's class notes are strangely funny. There's one section, for example, on "how to deal with kids on drugs." Another lesson concerned "preventing problem behavior" and "correcting misbehavior." These involved things like explaining positive and negative consequences; telling a child what to do instead of what not to do; and showing empathy.

Oddly, nowhere in the lesson does it say: Give the child an antipsychotic.

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Wparkspring 1 Like

Dear Sir:

If you would send me a fax number; I will show you more documents and damaging evidence against Greg Abbott. Abbott is guilty of covering up the private interest, rigging and fixing court cases in Harris County and actually anywhere in the State of Texas. Mr. Abbott has plead an erroneous 'executive privilege' in Harris County case 1724264 [ misdemeanor] in a case that Constable Ron Hickman filed against me when I complained about the murder and unaware at the time of the crime of the forged thumbprint.

The evidence tends to show Greg Abbott played a role in the forged thumb-print of October 28, 2010 and tried to use psycho-active drugs to shut me up for speaking out about the ugly realities of LINDY GATE. I am the ex- wife of Special Texas Ranger complaining about the murder of the ex- wife of Texas Ethics Commissioner, attorney Warren "Tom" Harrison.

Respectfully submitted,

Carol Ann Davis


They put me on Risperdal when I was 7 (in 1995). It made me wet the bed and caused me to fall asleep in class. It was humiliating because the teachers made me stand up in class and criticized my somnolence in front of everyone when the Risperdal made me fall asleep. In an interesting turn of fate, the doctor that prescribed me the Risperdal later had her license revoked for having too cozy of a relationship with pharmaceutical reps and other unethical behaviors. Next time I'm in Houston I'll ask the doctor's name, because I think the Houston Press might be interested in that.

Brian 1 Like

When I was 16 (in 1997), I smoked some laced weed, freaked out, landed in the hospital, and spent the next year and a half on Risperdal. I gained fifty pounds in just a couple months, and literally drooled my way through junior year of high school, a zombie. I kept trying to tell my parents and my doctors that this wasn't right, that these were side-effects of the drug, but their response was "Well, that's not what the science says." It was like living in a nightmare. Thank-you, Mr. Malisow, for telling the story of every kid like me who was drugged into a waking coma under the guise of being "helped."

Edward Opton
Edward Opton


I'd really, really like to talk with you. Would you please contact me? You can send your e-mail address to or phone me and leave a cal-back number. My phone number is 510-835-8098, ext. 3014.

Edward Opton

Tara Marshall
Tara Marshall 1 Like

As young as 3? I've seen it used on children as young as TWO, to my outrage. Risperdal calms a child down, yes, but it does it by completely sedating the child, also lowering his or her ability to LEARN. This should be a particular concern, since many children who receive this medication also have diagnoses of developmental disabilities, especially Autism.

I"ve also seen children gain weight to the point of becoming diabetic (and if you thought dealing with a severely Autistic child was hard to begin with, wait until he is insulin-dependent and hates both testing and needles), as well as children with side effects such as tardive dyskinesia (Parkinsonism) that were permanent even after the drug was removed. And I've seen a few cases of Neuroleptic Malignant Syndrome, which can KILL the person.

As far as I'm concerned, Johnson & Johnson is no less than criminally negligent in their treatment of children and adults in promoting this dangerous medication.


Drugging the children and adults, like this also allows room for sexual predators to have access, and its all planned, from the people with the knowledge about the drugs to the people with the money to buy the knowledge, and they have access to our children in foster care, or in respite care... they are not safe.. but the government knows this.. thier the ones with the money.. they are all for one and one for all.. unfortuneatly its hard core reality... itz time to change it all....Tina....


After working in the realm of residential/institutional foster care, I was shocked to learn, "In 2009, 65% [or 26,994] of the children in [TX] foster care, 59%, [or 15,932 children] lived in residential [institutional] foster care" (Children’s’ Commission, 2010, p. 12).

In 1975-'76, Texas sent foster children and children sentenced for petty crimes to Arcadia, Louisiana. LA would not send LA's "troubled" children to this god-forsaken place. The director and head pedophile, Mack W. Ford, took more girls than we will ever know across state lines (as we sang and told sad stories to fill the coffers), and molested and raped us in ways I never imagined possible. When he began molesting two and three girls at a time, he left witnesses. One committed suicide and the other two are hanging on by a thread.

He is still there, sitting on land purchased by donations to the nonprofit home/church/hell-hole, living in the two-story home built for the preacher man, and he's trying to sell the whole place for a sweet 2 M. The fool thinks he will pocket the money and he probably will.

To cause children to be unbelievable, the label of "troubled children" allows owners and staff persons to do anything they want. ANYTHING! I believe Ford and his wife (she knew) needs a boot straight to prison, put the property, or money, in a trust to help the kids who, as adults, are not able to move beyond the violence and sexual abuse Mack Ford and several of his pedo-friends, male and female, perpetrated on unsuspecting boys and girls. I had never been in trouble with anyone other than my parents, and knew children of families that fell apart, and were abandoned to Mack W. Ford's rather large hell-hole.

Several have committed suicide and I do not want to read about another of NB's survivors committing suicide. The FBI and Beinville Parrish Investigators will not do anything to his sorry self.

I went to New Bethany, thinking I was running to the loving arms of the family I never had. Had I known the truth, I would take my dad's beatings over Mack Ford's rapes any day of the week.


Terrific article.

The public is waiting for the medical profession to act in these children interests.There is no reliable data indicating the longterm beneficial use of anti-psychotics in children for any purpose.

The brain cannot make appropriate choices when subdued by the neurochemical equivalent of vodka.

So we turn children into angry drunks (or maybe they will fall asleep first) . . . .

Rosewiththorns 1 Like

I babysat this child a couple of weeks after she got out of foster "care". (I use parentheses because "care" is NOT what she got.....she was DRUGGED OUT OF HER MIND by CPS!) She told me that she cried and cried every day because she missed her parents so much. Even as this article stated, "her foster mother had initially complained of Rachel being hyperactive and uncooperative".

Now think about many children cry and get upset because they are taken away from the families that love them and that they love? I'd say every one of them. Now consider....if a child taken away from the only family they know and put into a home where they know NOBODY and are scared and traumatized from recently being taken away from their parents, don't you think they would be upset? Of course they would. But with's NOT ACCEPTABLE for a child to be upset. That's when they put them on DRUGS TO SHUT THEM UP! More money for CPS! The CPS caseworker even told Rachel's mother, who was crying as she ripped Rachel out of her arms, that she needed to stop crying or she would NEVER see Rachel again (Is this how they are supposed to treat the parents?????)!

Each child that is put on drugs earns CPS MORE MONEY for each child from the coffers of the state AND federal monies that are taken from our taxes that we pay. Now I highly doubt that the majority of children who have been traumatized by being snatched away by CPS need drugs, but to CPS it's all about the money! This has been going on for years, yet CPS has been very clever in covering up their lies and schemes, as well as living in the black hole between "state law" and "federal law". Because they are in this hazy area.....wait for it.....CPS is NOT REQUIRED TO ADHERE TO EITHER STATE NOR FEDERAL LAW BECAUSE THEY CAN PLAY ONE AGAINST THE OTHER! Is it sinking in yet????? Parents say it's against the laws of the state....CPS says they have approval by FEDERAL LAW. Parents say it's against Federal Law.....CPS says they have approval by STATE LAW. This is how they are able to play one side against the other. This has been going on for YEARS, yet nobody has wanted to do anything about it! Politicians I have talked to said they know CPS is corrupt, but they don't want to jeopardize their nice, cushy political seats because "CPS is too powerful".

Now you really want a government agency that is considered "too powerful to fight" in charge of our children? Do you know what they do when a child turns 18 in their care? On their 18th birthday, they are no longer considered "wards of the state" and the state and federal funding STOPS. The children are turned out into the street immediately to fend for themselves. Don't forget to consider the fact that the foster "famililes" no longer want these children (because they will no longer be paid to take "care" of them), and that CPS has destroyed all ties to their original familes so that these children literally have NOWHERE to go.

Now the question comes down to this: Are we, as a civilized society, going to continue to let CPS and the federal government continue to dictate to us HOW we are to raise our children, and let them take our children away at the whimsy of CPS and put them on drugs to keep them quiet while in foster care just so they can keep their revenue up? Already too many children have died while on these drugs, while CPS and the pharmaceutical companies keep the information "confidential"?

I dare any politician to go after these child kidnappers and child killers. I've already seen too many of you who are yellow bellied cowards! Makes me wonder....would they ignore the problem if it happened to one of their children or grandchildren?

Would you still support CPS if your child or grandchild was taken away and put on drugs?.....

You be the judge........


Jesus Christ... I'm a mom and luckily my kids are not prescribed anything. But this article BREAKS MY HEART! Stop drugging these babies and start effing taking care of them!


They are using Foster children to test the drugs on. The long term effects are not known.

Craig Malisow
Craig Malisow

Diando -- could you tell me where you're getting this information about drugs being tested on foster children? Which drugs are you referring to?

Craig Malisow
Craig Malisow

No prob' -- I appreciate your passion for the issue!


I understand.... It got off subject.. Thank you for pointing that out.


Drug experimentations conducted by pharmaceutical giants have killed 893 Turks, the Independent reported. Turkey is listed sixth of the countries that report the most deaths due to experimentations, with India taking the lead at over 1,700 victims who lost their lives during experiments run by American, British and European pharmaceutical companies. The Independent’s investigation revealed plenty of gruesome details including experiments cancelled following abuses of illiterate or uninformed subjects in need of either money or treatment. The total number of world deaths caused by pharmaceutical experimentation runs as high as 120,000. The issue is reportedly caused by tight regulations in countries like the United States and England, which push the pharmaceutical companies to direct their studies to countries that have looser ethical and technical regulations. Read Story Here…

Craig Malisow
Craig Malisow

Hi Diando -- I understand the seriousness of this issue, but just wanted to again point out that my story has nothing to do with testing drugs on foster children.


Since Merck's ethics were considered exemplary within the pharmaceutical industry -- one has to wonder how much lower one needs to stoop to find the business ethics under which the rest of this industry operates.

Those best situated to bring this industry's immoral conduct to a screeching halt, are its shareholders.

The role of pharmaceutical companies came up at a hearing convened by the Committee on General Welfare of the New York City Council in which the commissioner of NYC's Administration of Chilren's Services (ACS) was grilled about the unethical drug experiments that were conducted on at least 645 infants and children who were under the guardianship of ACS.

The children were exposed to experimental AIDS drugs and vaccines in Phase I and Phase II trials sponsored by the National Institutes of Health, often in concert with drug manufacturers. All institutions and government agencies involved have been unforthcoming about the trials and the fate of the children.

One after another Council member expressed his disgust with "the moral turpitude of pharmaceutical companies" whose involvement in the trials raises red flags about the financial underpinnings of the trials.

Contact: Vera Hassner Sharav212-595-8974


A Russian hospital is being investigated for allegedly illegally testing GlaxoSmithKline vaccines on toddlers, making them ill and hampering their development. GlaxoSmithKline denied the claims, saying there was evidence of neither adverse events nor misconduct.

The vaccines were tested on over 100 children aged 1 to 2. Prosecutors claim that parents were not properly informed, and thought that the vaccinations were routine.It was also alleged that sick children had been illegally used in the clinical trials; only healthy children were allowed to receive the vaccine according to the contract. One girl had a neurological illness that progressed quickly after the vaccination.


Pfizer Implicated in Human Drug Experimentation on Critically Ill Children in Nigeria

Mike AdamsNaturalNews Wednesday, Nov 26, 2008

Did Pfizer recruit critical ill Nigerian children for illegal drug experiments? That's what the Nigerian government is charging in an $8.5 billion lawsuit against the drug maker. To avoid a court battle, Pfizer is offering to pay off the Nigerian government with $150 million in drug money, hoping it will drop the case and end what could potentially be a public relations nightmare for the drug maker.

Anyone familiar with the true history of drug companies knows that many of them have a long, dark history of experimentation on human beings. Read the shocking timeline of human medical experimentation here:

Drug companies, of course, routinely conduct drug trials outside the United States these days, away from public scrutiny and regulations involving basic human rights. In my opinion, drug companies exploit these third-world children, using them as guinea pigs to gather manipulated clinical trial data for their drugs, then they turn around and sell those same dangerous drugs at criminally-high markups to citizens of wealthy first-world nations.

The true stories of drug companies using citizens of third-world countries for vaccine experiments and dangerous drug trials are horrifying, to say the least. But it's even worse when you realize that, for the most part, Big Pharma is also experimenting on virtually everyone, since most of their new drugs have never been proven in long-term safety trials anyway.


They are mostly used for Aid's however, if they are using them for aids experiments you can bet it's being done for more than that.. I posted some of the articles and they are waiting for approval.

Craig Malisow
Craig Malisow

Well, actually, that's not what I wrote. My story has nothing to do with testing drugs on foster kids. I think that's pretty clear.


It's in your article, dude - read what you wrote. They don't know the efficacy or long-term effect, but while we have this nice captive population (a la Tuskegee), let's try this stuff on them and see what happens at this doe and this age, write up the results, publish it, and use it to bootstrap our drug into legitimacy.


I am not surprise this kind of medical abuse is practiced on children , while living in Florida it was a common practice for foster children to be given numerous drugs without a valid reason. The medical profession has been corrupted by money for many years by the giveaways from the drug companies. This is a civil rights issue I believe that a organization such as the ACLU of Texas should be alerted to this issue, of abusing minors by drugging them!!!


ACLU is aware of this.. They choose to ignore it.. In our case anyway..


Let us take an example of Texas. The "Penny Medical" is quite popular in Arizona. It provides so many offers for the low income people.


My daughter was given risperdal for what we were told was possibly ADD/ADHD and depression at age 6 (but later/other dr.s identified PTSD). She is off when I refused to give her anymore - it took her 5 mos to go from sad, A+ student, low avg weight to obese; adrenal problems, thyroid problems, glucose problems; and excessive anger/violence, avg grades. They say now adrenal is ok, glucose is still borderline, but thyroid is pretty much shot! They created a lifelong nightmare for my child. Thyroid controls everything else - so if she drinks milk - it prevents thyroid meds from working and here come the thyroid side effects. I wish I had an attorney to sue the pants off J &J and the Dr that prescribed it, yet ignored my warnings about side effects until it was too late to un do!


Good luck finding an attorney with the knowledge and balls to sue CPS' and their actors. Our laws make them bullet-proof and they abuse us with impunity.

When I first saw the pics of Rachie after she was in foster care, I cried. This was the same little girl who we had played with and spent over a week together. Rachie needed someone to play and be active instead of sitting on their ass; not drugs.

I know another child, who developed hypothyroidism while in foster care. When his kidneys were affected, CPS finally had his medication reduced. Drugging kids is much easier than teaching children what they are supposed to do... sickening..


Has anyone tested if Cps are really bulletproof?


I called twice and phone went to voice mail.I left my name and number.


Yes, of course. Call me at 510-835-8098, ext. 3014, and I'll explain what I have in mind and why. For general background on my organization, please see


Could you share your motives?



I'd like to talk with you. Please call me at 510-835-8098, ext. 3014 or e-mail me at eopton[at]

Jwright 1 Like

I recall hearing CPS caseworkers, say they made more money by joining CASA in a supervisory position. Once a supervisor with CASA, later on the once caseworker may return to CPS in a supervisory position and at a higher pay scale.

19 years ago, I volunteered with CASA and the majority of employees were previously CPS workers. One woman was with CASA when I met her and previously she worked for CPS. She changed to CASA because the workload was lighter and there was less "chick-shit" at CASA. Several years ago, I ran into her at the courthouse and she had returned to CPS, in a supervisory role. With CPS workers becoming CASA workers and CASA workers becoming CPS workers, the CPS attitudes became incestuous with CASA.

Join CASA, attend the training sessions (used to be 30 hours) and you will have access to judges, CPS Supervisors, and lots of Caseworkers.

While at a fancy luncheon at the Junior League, I listened to CPS Agents and CASA Agents talk about their cases and specific families, incidents, and children; typically, laughing and making jokes about "foolish" statements made by distraught parents. Two CPS workers were literally doubling over laughing when describing how they went out at night and one hid with a camera, while the other knocked on the door. As soon as the father (ordered to leave the home) opened the door, the person with the camera took a picture and the next day in court, the parents' rights were terminated because mom was not following CPS' rules.

Warranted or not, there is nothing funny about the pain and sheer agony so many parents that I work with manage. The majority of parents I work with were deemed neglectful in caring for their children.

Evidently, CASA does not complete background checks on CPS caseworkers. Awhile back, a background check of a CASA who was hell-bent on punishing young boys, revealed she was convicted of doctoring a government document and sentenced to probation; however, less than six months later, she had a DWI and probation revoked.

Her resume includes working for the Texas Department of Corrections (TDC), reintegrating prisoners into society. She did not work for TDC, she was a prisoner! . For the six or seven years she worked for CPS, she was convicted once or twice each year for writing hot checks. When a check bounces, most would simply pay the fees and whatever is owed. No... she had to be arrested and taken to jail once or twice a year.No one threatened to take her child! This CASA gave a mother pure hell because her son missed a therapy session because he was sick and running a fever. The way she spoke to this mother, one would have thought the mother was a convict, but this mother has never been convicted of anything.

The agency is broken beyond repair.


Can someone explain: why would an ex-CPS worker become a CASA? What is the motive? Or motives?


Bremnes, Maybe "bullet-proof" is the wrong terminology; lawsuit-proof would be more accurate. CPS in Texas is "lawsuit-proof" because of the immunity afforded the agency and their minions, which includes judges who appear to be nothing more than a mouthpiece for CPS.

Suing CPS for wrong and illegal actions is more likely to land the plaintiff in bankruptcy court than to afford justice for a child. $67,000.00 was nothing compared to the endless budget for CPS' legal team.

With the incestuous relationship between CPS and CASA, the original intent of CASA (providing an independent voice for children) rarely occurs. Many supervisors and Advocates at CASA used to be CPS workers. CASA and CPS may as well merge into one organization and save the taxpayer's money.

San Antonio CASA touts, "Ninety-nine percent of the time, the judge agrees with our volunteers' recommendations for final placement" (CASA, If the web site is accurate, then 99% creates the appearance of bias, thus violating the Judicial Canons.

Danny Haszard
Danny Haszard

PTSD treatment for Veterans found ineffective.Eli Lilly Zyprexa can cause diabetes. I took Zyprexa Olanzapine a powerful Lilly schizophrenic drug for 4 years it was prescribed to me off-label for post traumatic stress disorder was ineffective costly and gave me diabetes. *FIVE at FIVE* The Zyprexa antipsychotic drug,whose side effects can include weight gain and diabetes, was sold for "children in foster care, people who have trouble sleeping, elderly in nursing homes. *Five at Five* was the Zyprexa sales rep slogan, meaning *5mg dispensed at 5pm would keep patients quiet*. -- Daniel Haszard Zyprexa victim activistFMI zyprexa-victims(dot)com

Danny Haszard
Danny Haszard

Be aware of drugs that potentiate diabetes.Eli Lilly Zyprexa Olanzapine issues linger.The use of powerful antipsychotic drugs has increased in children as young as three years old. Weight gain, increases in triglyceride levels and associated risks for diabetes and cardiovascular disease. The average weight gain (adults) over the 12 week study period was the highest for Zyprexa—17 pounds. You’d be hard pressed to gain that kind of weight sport-eating your way through the holidays.One in 145 adults died in clinical trials of those taking the antipsychotic drug Zyprexa. This was Lilly's #1 product $5 billion per year sales,moreover Lilly also make billions more on drugs that treat diabetes.--- Daniel Haszard Zyprexa activist and patient.

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