Good News About Benzodiazepines for Foster Children—and a Puzzle

by Edward Opton 

The good news about benzodiazepines and foster children, at least in California, is that “benzos” (such as Ambien, Xanax, and Klonopin) are rarely prescribed for foster children in this state. A well-placed source tells us the reason is that the physicians who treat foster children are well aware of the dangers of these drugs.

The puzzle is: why only benzodiazepines, and why only in the foster care context? The dangers of the other major classes of psychotropics, antipsychotics and antidepressants, have not impeded prescribing those medications to thousands of California’s foster children. All three classes—benzodiazepines, antipsychotics, and antidepressants—continue to be administered in large quantities to another major class of non-voluntary drug-takers: elderly patients in nursing homes, not to mention the large numbers of psychotropic medication users who are neither children nor elderly.

It would seem that most prescribers to foster children, at least in California, have learned important information about benzodiazepines and children—don’t prescribe these drugs for foster children—but that learning, so far as we can determine, has not come through the usual formal channels. What’s more, that caution apparently has not generalized to other classes of psychotropic medications. The puzzle is: why is the prudence limited to benzos in foster care? Why not other psychotropic medications and other types of patients?

We hope some of our readers will provide the answers or at least a clue. Someone must know what happened. The spreading of well-merited caution that is protecting California’s foster children from unnecessary and potentially harmful benzodiazepines probably could be duplicated for other classes of psychotropic medication—if we knew how that dissemination of knowledge occurred. Who did it, and how?

Do you know?

(Sources:, “Still mistreating the elderly with psychiatric drugs: benzodiazepines” (10.28.15), “Still mistreating the elderly with psychiatric drugs: antipsychotics” (10.28.15), “More than two-thirds of antidepressants prescribed against guidelines” (10.27.15); citing: Takayanagi, Y., et al., Antidepressant use and lifetime history of mental disorders in a community sample: results from the Baltimore Epidemiological Catchment Area Study, 76 J. Clin. Psychiat. 40 (2015); Olfson, M., et al., Antipsychotic treatment of adults in the United States, 76 J. Clin. Psychiat. 1346 (2015); Marra, E.M., et al., Benzodiazepine prescribing in older adults in US ambulatory clinics and emergency departments (2001-10), J. Amer. Geriatrics Society 2015 (abstract) (


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