New Chemical Restraint

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New Chemical Restraint

“Overall use of psychotropic drugs did not decrease but rather the use of psychotropic drugs shifted toward a different category.”

–OIG Report.

The Washington Post reported on a scary trend in nursing homes. Patients are often drugged as a matter of convenience for the nursing home staff or to reduce annoying behavior, not for safety reasons. For years experts and advocates have warned about chemical restraints in the industry. The use of drugs to sedate dementia patients exposes them to dangerous potential side effects. Critics of the practice, known as “chemical restraint,” say it is inhumane if not practiced appropriately.

Antipsychotics carry a “black box” warning from the Food and Drug Administration because of the risk of stroke, heart attack, diabetes, parkinsonism and falls. Some anticonvulsants carry the risk of liver toxicity and inflammation of the pancreas. Government policies prohibit excessive use of powerful psychiatric drugs for dementia patients in nursing homes. However, now they are using anti-seizure medications to sedate residents.

Office of Inspector General for the Department of Health and Human Services

The OIG released substantial evidence shows nursing homes sedate dementia patients with anticonvulsant medications rather than antipsychotics. The OIG’s report studied psychotropics. It focused on drugs given to nursing home residents from 2011 to 2019.

The analysis highlights a long-standing issue: how nursing homes often do not provide the most appropriate care for residents with dementia.

“The inappropriate use of dangerous and powerful medications hasn’t really changed, and that is really disturbing.”

–Richard Mollot, executive director of the Long Term Care Community Coalition.

A report published this month in the Journal of the American Geriatrics Society made similar findings. No drugs are approved to treat dementia. Physicians may prescribe medications “off label” if safe and necessary.

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