Today I want to enter into a not widely appreciated topic which is on the face of it very controversial, the use of an abused drug/medication for intractable psychiatric depressions. This drug poses some very unique dilemmas for the psychiatric health care systems in the western world. First, it is in certain circles, e.g., the goofy idiotic rave club culture and its offshoots, an abused drug whose extent of use now may not really be known; but a few years ago it was getting enormous play in the 24 hour media and one would think that every young adult between 18 and 39 who danced in clubs or went to concerts was high on this stuff, getting raped and jumping off buildings, or going psychotic and “never coming back.” Second, it is a generic drug having passed of branded status decades ago and now cheap and offering the pharmaceutical companies no real inducement to develop as a new drug unless they blatantly did what they do with “me too” drugs as I call them: develop a known medication for a new use, bring it out under a new name and charge an unjustified sociopathic gazillion dollars a dose because it is able to patented and sold under a new idiotic name for a different indication or illness. Such is how our drug development system is perverted these days of hypercapitalism. Third, this drug has been used for a legitimate use and crucially and responsibly so for a few decades.
It would be easy to haul off irresponsibly and start blaming anyone and everyone in the NC state prison system for its latest sad tragedy, that of an inmate reportedly dying of thirst apparently this past March 12, 2014 according to a story, September 27, 2014, in the Charlotte Observer in an Associated Press story likely in other major papers in the state. It was written by Michael Biesecker, long time reporter in NC who along with other reporters such as Lynn Bonner of Raleigh has written extensively on the long term painful changes the state, like so many other states, has gone through in its own version of mental health reform. For the complete story, follow this URL, http://www.charlotteobserver.com/2014/09/26/5201687/nc-inmate-died-of-thirst-after.html.
To build on the first post in this blog and series, I reprint below one pragraph of the article penned by Dr. Paul S. Appelbaum MD May 29, 2014, a veteran psychchiatrist in the US whose opinion I respect highly. His entire article on rebuilding the American mental health system from the US edition of the British newspaper The Guardian is found at http://www.theguardian.com/commentisfree/2014/may/29/-sp-fix-america-mental-health-system-ideas. Continue reading
This initial post to this blog will introduce the reader to what this blog will be mostly addressing: the ongoing crisis in the United State’s mental health treatment system. I as a psychiatrist started tracking this slow motion crisis in the 1980’s when the state of Massachusetts uinderwent a number of changes under the then new and catchy codephrase of the future” mental health reform. It began with statewide changes in mental health funding; while lauded, it resulted in such disastrous funding for mental health services that one of the then medical school psychiatric departments, Tufts Medical School, had to sell off its child psychiatry service to Harvard to survive and continue to operate. Then the state of Michigan under the then Governor, Republican John Engler, whose approach foreshadowed the cut mental health funding approaches of the future in his multi-term tenure as governor slashed the state’s mental health system, closed state hospitals and reduced state hospital psychiatric beds by over 50%, and privatized the system in short order, throwing the system into chaos. Continue reading