LOS ANGELES - s4story -- Tennessee has enacted two landmark measures addressing psychotropic drug use. The first expands toxicology testing in cases of mass violence. The second requires detailed, privacy-protected reporting on prescriptions in Medicaid and foster care. The Citizens Commission on Human Rights (CCHR) International says these forward-looking reforms represent a strong and timely response to growing national concerns over psychiatric drug risks, demonstrating effective models of transparency and oversight that are urgently needed at the national and federal levels.

Tennessee lawmakers enacted a landmark measure that took effect July 1, 2025, requiring toxicology testing for psychotropic drugs in autopsies of decedents suspected of committing a mass shooting resulting in four or more deaths.[1] An enacted expansion (effective July 1, 2026) broadens this to those in which four or more individuals sustain injury (not limited to deaths), or where a reasonable person would conclude the perpetrator attempted to kill four or more individuals. It also extends provisions to living suspects: with probable cause, law enforcement may request consent for a blood or urine test to determine psychiatric drug presence.[2]

A key feature is the requirement to test for therapeutic levels of psychotropic drugs, allowing detection of even low amounts in the blood to identify recent or irregular intake that may still affect behavior. This establishes a critical new precedent for addressing potential drug-induced violence. Unlike past tragedies such as Sandy Hook, where toxicology testing omitted therapeutic levels, Tennessee's law now mandates these precise measurements.

Advocates say these measures set an important precedent for better understanding and addressing violence potentially linked to these prescription drugs.

Comprehensive Psychiatric Drug Tracking in Medicaid and Foster Care

A second new law, The Psychotropic Medication Data Transparency Act 2026, arose from a months-long effort to obtain psychotropic drug prescribing data that Tennessee had never consistently tracked. It mandates comprehensive collection and public reporting of psychotropic drug prescriptions for community use and the foster care system, and associated costs.[3]

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In 2024, CCHR International filed Freedom of Information Act (FOIA) requests to gather data from 32 states on children prescribed psychotropic drugs under Medicaid and the costs. This found 9,882 children aged 0–5 were prescribed psychiatric drugs in 2023. After reviewing this information, Brittany Ruiz, Director of Public Policy for CCHR Tennessee, sought more Tennessee-specific data. As of January 2022, 25% of Tennesseans were taking psychotropic drugs—an increase of 15% from the prior year.[4] Approximately 1 in 3 foster children in Tennessee were on psychiatric drugs according to 2018 state-specific data, with more recent national Medicaid analyses showing rates near 35% as of 2023.[5]

Ruiz drafted the bill, which was championed by Representative Brock Martin and Senator Brent Taylor. With strong bipartisan support, it passed with nearly unanimous approval.

The collected reports include:

• The number of persons prescribed at least one psychotropic drug, broken down by age groups: 0-5, 6-12, 13-17, 18-64, and 65 and older.
• The number of distinct covered outpatient psychotropic drugs paid through TennCare per person over one year, categorized by county and age range.
• The total cost of psychotropic drugs paid by TennCare, with separate subtotals for state and federal funds, categorized by age group.

A separate section addresses children in state custody (foster care), covering:

• Numbers by age groups (birth to 5, 6-12, and 13-17).
• The number of distinct psychotropic drugs prescribed per child over one year when received for 90 days or longer.
• Total costs for these prescriptions.

All reports are prepared in aggregate, de-identified form to comply with privacy laws, demonstrating that effective oversight is possible without compromising patient privacy.

National Context and Call for Informed Consent

CCHR International's collected FOIA data from the 32 states showed that 2,999,084 children aged 0–17 were prescribed psychiatric drugs under Medicaid in 2023. This included 270,196 children aged 0–5, at a total taxpayer cost of $1.78 billion.[6]

ADHD stimulants (DEA Schedule II controlled substances) were the most commonly prescribed, given to more than 1.4 million children aged 0–17, including 89,392 aged 0–5. Antidepressants followed (920,411 children aged 0–17, including 25,414 aged 0–5), carrying an FDA black box warning for increased risk of suicidal thoughts and behaviors in youth. Anti-anxiety drugs were third (605,746 children aged 0–17, including 145,783 aged 0–5), with warnings about dependence and withdrawal. Antipsychotics were prescribed to 465,559 children aged 0–17 (including 34,758 aged 0–5), associated with risks such as diabetes, movement disorders, cardiovascular issues, and neuroleptic malignant syndrome.

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These prescribing levels and documented risks demand greater informed consent. CCHR recommends that the FDA Medication Guide—plain-language fact sheets detailing the most serious side effects—be provided directly by prescribing doctors with signed patient acknowledgment. While pharmacists currently distribute them, CCHR calls for this to become a standard part of the physician's prescribing process.

Jan Eastgate, President of CCHR International, said: "Tennessee's dual landmark laws set a powerful new standard for transparency and accountability. They directly address growing concerns over the potential risks of these drugs, the urgent need for complete data, and persistently poor mental health outcomes. With federal measures now calling for deprescribing, it is time for comprehensive, transparent oversight to become the standard across America."

CCHR is a nonprofit mental health watchdog founded in 1969 by the Church of Scientology and professor of psychiatry Thomas Szasz, University of New York, Upstate Medical University. It has secured hundreds of laws protecting patient rights, including the U.S. Prohibition on Mandatory Medication amendment, banning children from being forced to take psychotropic drugs to remain in school.

Sources:

[1] "Tennessee Sets National Precedent with Passage of AbleChild Bill Requiring Psychotropic Drug Testing in Mass Shooter Cases," AbleChild, 30 Apr. 2025, www.ablechild.org/2026/05/21/tennessee-doubles-down-on-new-toxicology-law-that-broke-the-silence-on-psychiatric-drugs-mass-shootings/

[2] capitol.tn.gov/Bills/114/Bill/SB2088.pdf

[3] wapp.capitol.tn.gov/apps/BillInfo/Default?BillNumber=HB2389&ga=114

[4] Tennessee Accountability Center, "The Center for State Child Welfare Data – Tennessee Accountability Center Report," Department of Children's Services, 31 May 2018

[5] Keefe, Rachael J., et al., "Psychotropic Medication Prescribing: Youth in Foster Care Compared with Other Medicaid Enrollees," Journal of Child and Adolescent Psychopharmacology, May 2023

[6] www.cchrint.org/massdrugging-of-medicaid-children/; Dr. Roger McFillin, "We Call It Medicine: The Mass Psychiatric Drugging of America's Poorest Children," Radically Genuine, 10 Mar. 2026, drmcfillin.substack.com/p/we-call-it-medicine-the-mass-psychiatric?utm_medium=email&action=share