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The Use of Neuroleptic Drugs As Chemical Restraints in Nursing Homes

July 17, 2014 By Phil Hickey |

There’s an interesting article in the July-August 2014 issue of the AARP Bulletin.  It’s called Drug Abuse: Antipsychotics in Nursing Homes, and was written by Jan Goodwin.  AARP is the American Association of Retired Persons.   Jan Goodwin is an investigative journalist whose career, according to Wikipedia, “…has been committed to focusing attention on social justice and human rights…”

The article is essentially a condemnation of the widespread and long-standing practice of using neuroleptic drugs to suppress “difficult” behavior in nursing home residents.

Here are some quotes:

“According to Charlene Harrington, professor of nursing and sociology at the University of California, San Francisco, as many as 1 in 5 patients in the nation’s 15,500 nursing homes are given antipsychotic drugs that are not only unnecessary, but also extremely dangerous for older patients.”

“‘The misuse of antipsychotic drugs as chemical restraints is one of the most common and long-standing, but preventable, practices causing serious harm to nursing home residents today,’ says Toby Edelman, an attorney at the Center for Medicare Advocacy in Washington, D.C.”

“If one drug caused sleeplessness and anxiety, she was given a different medication to counteract those side effects. If yet another drug induced agitation or the urge to constantly move, she was medicated again for that.”

“Antipsychotic drugs are intended for people with severe mental illness, such as patients with schizophrenia or bipolar disorder. As such, they carry the FDA’s black-box warning that they are not intended for frail older people or patients with Alzheimer’s or dementia. In those populations, these drugs can trigger agitation, anxiety, confusion, disorientation and even death. ‘They can dull a patient’s memory, sap their personalities and crush their spirits,’ according to a report from the California Advocates for Nursing Home Reform.”

There’s an implication in this quote that neuroleptic drugs have these adverse effects only on frail older people.  In fact, they have these effects on almost everybody who takes them.

Back to the AARP article:

“And pharmaceutical companies have been aggressively marketing their products as an easy and effective way to control these issues.”

Gwen Olsen’s book Confessions of a Rx Drug Pusher (2009) provides some very compelling insights into this kind of pharma marketing, e.g.:

“It was the end of the third quarter, and I was behind in my sales quota for Haldol…So, I determined the best way to build my Haldol business would be to campaign for the institutionalized patient. These patients were not only encouraged to take the medication; they were actually given the drug. This completely eliminated the compliance issue.”

“I set about scheduling training in-services in the local nursing homes and mental health and mental retardation (MHMR) facilities. I increased my call frequency on physicians whom I knew to have nursing home relationships and directorship responsibilities.” (p 48) [Emphasis added]

. . . . . . . . . . . . . . . .

It is particularly heartening to see an article like Jan Goodwin’s in an established magazine such as AARP Bulletin (readership 37 million +).  It represents a huge advance over the take-your-psychiatric-medication-as-the-doctor-ordered drivel that passes for journalism in most mainstream media outlets.  I commend Jan Goodwin, and hope that we see more material of this sort in the future.

At the same time, however, I was disappointed in that the role of psychiatry in the promotion of these neurotoxic chemicals was not even mentioned.  Responsibility for the problem was laid at the feet of pharma, whose aggressive, irresponsible marketing was unequivocally condemned.

But pharma doesn’t write prescriptions.  And pharma didn’t invent the “illnesses” that legitimize these prescriptions.

For the past sixty years, psychiatry’s primary objective has been to promote the spurious and destructive notion that virtually every human problem is an illness.  Their efforts have been extremely successful, and this false notion today permeates our culture, our language, our political and social institutions, and even our nursing homes.

Using dangerous, toxic chemicals to drug a frail, elderly person into submission is possible because psychiatry has invented and sold the fiction that his agitation, anxiety, and aggression are illnesses, and that the toxic chemicals are medications.  Pharma certainly funded the fraud, but it was psychiatry that conducted the “validating research.”  It was psychiatry that codified and formalized the spurious diagnoses into a manual.  And it is psychiatry that lobbies unremittingly for the acceptance of these “diagnoses” by government entities and by other professions.

And this was not an innocent error.  Psychiatrists invented and promoted their fictitious illnesses and their destructive “treatments” to promote their own aspirations to be seen as a legitimate medical specialty, and to expand their business, their influence, and their prestige.

In this process, they have created a monster that feeds on human life, but they continue to insist, against rapidly mounting evidence, that their “diagnoses” are valid and their “treatments” effective, and have engaged the services of an international PR firm to marginalize their opponents and to sell this travesty to the public, the media, and the political establishment.  Psychiatry is not something that is basically OK, that just needs some minor corrections.  Rather, psychiatry is something fundamentally flawed and rotten: a wrong turning in human history; a blot on humanity’s collective conscience.

Let us hope that we see more articles like this in the mainstream media, and that more investigative journalists like Jan Goodwin will find the motivation and the courage to speak out against this disempowering and destructive edifice whose shadow has for too long been allowed to darken the hopes and aspirations of people of all ages.

 

Filed Under: A Behavioral Approach to Mental Disorders Tagged With: expansion of psychiatric turf, neuroleptics, over-medicalization of everyday life

About Phil Hickey

I am a licensed psychologist, presently retired. I have worked in clinical and managerial positions in the mental health, corrections, and addictions fields in the United States and England. My wife Nancy and I have been married since 1970 and have four grown children.

 

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