Mental Illness and Prescription Narcotics

Our collective understanding of mental illness in the U.S. has evolved rapidly in recent years. Still, it’s widely stigmatized and not as thoroughly researched as other areas of health. That means sufferers are still vulnerable to a myriad of medication hazards.

Boston personal injury attorneys of Jeffrey Glassman Injury Lawyers recognize that while medications can often help to ease the symptoms for some mental illness sufferers, these substances also have the potential to do great harm.

In too many cases, physicians overprescribe powerful medications, and those with mental illness are especially susceptible. Red flags have been identified especially with antipsychotics, particularly at in-patient care facilities. The problem encompasses patients of all ages, though studies released in the last few years indicate elderly dementia patients are at high risk – despite minimal benefit and great consequence to their overall health.

When doctors prescribe these powerful drugs in an effort to quell immediate behavior problems, it’s a form of “chemical restraint,” and it can be dangerous to patients.

In some cases, heavy drugs are prescribed to keep “problem patients” calm, but these regimens aren’t always in the patients’ best interests.

Doctors aren’t always the only ones to blame. Drug maker Johnson & Johnson was ordered by the U.S. Justice Department to pay more than $2.2 billion to resolve federal criminal and civil investigations into its promotion of off-label uses and misbranding of antipsychotic drugs to elderly patients.

Even those who aren’t receiving in-patient care may be prescribed potentially dangerous medications, such as anti-anxiety drugs and antidepressants. These are some of the most-prescribed substances in the U.S. – and possibly the most dangerous – and researchers say a quarter of patients don’t even have an accurate and proper diagnosis.

There is also ample evidence to suggest doctors are quick to treat certain mental health disorders with sleep medications. While it’s true that sleep disorders are correlated to mental illness, many of these medications are highly addictive and can be dangerous when their use isn’t properly monitored. Even drugs that are less habit-forming could put a patient in peril, especially when those medications are combined with others.

Doctors, health care facilities and drug manufacturers may be held liable for damage inflicted on patients and loved ones as a result of the negligent or reckless distribution of dangerous medications for the mentally ill.

The National Alliance on Mental Illness (NAMI) indicates 1 in 4 adults – or nearly 62 million Americans – suffers from some type of mental illness every year.

Other findings from the agency include:

• Some 13.6 million Americans live with a serious mental illness, such as major depression, bipolar disorder or schizophrenia;
• About 42 million people suffer from some type of anxiety disorder, such as posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, and generalized anxiety disorder;
• Co-occurring mental illness and addiction is a daily struggle for 9.2 million adults;
• Some 20 percent of youth 13 to 18 suffer severe mental disorders.
• Thirteen percent of children between the ages of 8 and 15 suffer severe mental disorders.

An astonishing 60 percent of those who suffered from mental illness received no mental health services in the last year. But even for those who do seek or receive help, the system is imperfect.

Chemical restraints, also known as “emergency restraints, as defined in 115 CMR 2.01 involves the non-consensual use of medications for purposes of impairing a person’s freedom of movement.

In Massachusetts, the use of chemical restraints is not illegal, but it should be carefully executed. Some of the rules for chemical restraints are that:

• They must be licensed by an authorized physician in attendance or by a physician who has consulted with an RN, NP, PA or another doctor by phone;
• An order is good for a single treatment and cannot be renewed;
• Chemical restraint forms and comments from patients have to be documented and filed with the Department of Developmental Services after each instance.

These types of chemical restraints are supposed to be a last resort when a patient is violent and poses a threat to himself or others.

A study published in 2015 by the journal JAMA Psychiatry analyzed care for some 91,000 U.S. military veterans over 65 with dementia. What they discovered was that those patients who were prescribed antipsychotic drugs had an outsized risk of death. In particular, these patients were more at risk for cardiovascular trouble.

Meanwhile, the U.S. Government and Accountability Office reported in 2012 that one-third of adults with dementia in nursing homes were prescribed antipsychotic medications.

Drug maker Janssen, a subsidiary of Johnson & Johnson, pleaded guilty in 2013 to misbranding its antipsychotic drug, Risperdal, for treatment of elderly dementia patients when in fact, it was only approved for treatment of patients with schizophrenia. While doctors aren’t prohibited from writing off-label prescriptions, drug companies aren’t allowed to promote uses other than those approved by the U.S. Food & Drug Administration.

There is no question that there are many people who need and benefit greatly from anti-anxiety medications to treat a wide range of disorders.

However, Psychology Today reports that 25 percent of people given psychotropic medications for these conditions don’t have a proper diagnosis. Drugs are in many cases given simply as a way to suppress general mood issues or to help people with insomnia.

What’s worse, those who use anti-anxiety medications have a 36 percent increased risk of mortality.

Drugs that fall into this category include:

• benzodiazepines (i.e., Xanax, Valium, etc.)
• sedative hypnotics (i.e., sleeping pills)
• minor tranquilizers

Pharmacy companies rake in approximately $21 billion annually selling these medications, and they have a duty to do so responsibly.

Physicians and other health care providers, recognizing the potential for adverse side effects, must also prescribe these drugs with great care and supervision.

Contact the Boston personal injury lawyers at Jeffrey Glassman Injury Lawyers by calling (617) 777-7777.