by Chris Holmes
Twice before I have mentioned the scandal of people of a certain age who are more frail and confused than they used to be being knocked senseless by GPs with the use of powerful anti-psychotic drugs, and now this scandal is back in the news again.
No-one is suggesting that the job of a GP is easy. A great number of the decisions a GP will make when considering whether to prescribe a certain medication or whether not to, will be a judgement call, and it is possible to get that wrong. That’s why they have advisory bodies like N.I.C.E. to give them guidelines.
The trouble is, quite a lot of GPs are ignoring the guidelines. These drugs are designed for people who are psychotic, but of the 180,000 people currently being prescribed these drugs in care homes, it is reckoned that about two-thirds of them aren’t psychotic – they are confused, suffering from some form of dementia or are just agitated about the transition of going into care.
The Telegraph’s Health Correspondent Beezy Marsh wrote:
The findings emerged in Keep Taking the Medicine, a report by Paul Burstow, the Liberal Democrat spokesman for older people, who obtained information through parliamentary questions.
Last night he said: “The chemical management of older people is a continuing scandal.
“It denies older people dignity and robs them of a better quality of life. Pressures on care providers are not an excuse for inappropriate medication.
When I first commented on this a year or so ago, I was horrified by the estimate that in the previous five years, these medications were reckoned to have killed about seven hundred people – mainly through causing strokes and pneumonia. Now the estimates are between 1000 and 2000 elderly people being killed in this way every year yet the N.I.C.E. guidelines are that unless the patient is psychotic, these drugs should not be used to sedate them. They are so powerful that they are now being spoken of as a kind of “chemical cosh”, and the accusation is that this dangerous practice is simply to make these people less troublesome and easier to handle.
The Telegraph again:
Frank Ursell, chief executive of the Registered Nursing Home Association, said accused Mr Burstow of “pointing the finger of blame”. He said: “We want to disassociate this idea of these drugs being used as a chemical cosh, because it is just not true.
“If you are running a home, you do not want people wandering around in a sleepy state. They can be useful to help people settle in, because it can be very traumatic for elderly people when they first arrive, to bridge that gap.
“It is the GP who prescribes the drug and to suggest that there is inappropriate prescribing is a scurrilous attack on GPs.”
“Help people settle in”? Settle in to what, a shroud? And this is not just a “suggestion” that the drugs are being mis-prescribed – clearly the guidelines are being ignored which is causing the deaths of over a thousand people a year!
Look, if someone is upset or agitated, or having trouble adjusting to a new way of life, you could just give ’em a Valium or something like that. You don’t have to put them on a tablet designed for something completely different that also has the slight drawback of killing a thousand people a year, thus deliberately ignoring the official guidelines that tell you not to do that. Forgive me, but that is not “a scurrilous attack on GP’s”. And yes, it is “pointing the finger of blame” because GP’s ARE to blame for that one! There are times, Mr Ursell, when pointing the finger of blame is entirely appropriate, and when GPs cause unnecessary deaths by choosing to ignore the official guidelines – not just once or twice but in thousands of cases annually, then clearly the blame lies WITH THEM… not with N.I.C.E., not with the care homes, not even in this case with the drug companies who manufacture the damn stuff, but the individuals that sign those prescriptions.
I did call it, last time, a Licence to Kill. GPs know that if any of these old folk die as a result, no-one is going to sue them personally. How is this different from Shipman’s arrogant assumption that he should remain untouchable if he killed people off with the inappropriate use of medication? And it is clearly ageism: would they even dream of deliberately knocking out any other section of the population en masse with these drugs? It isn’t really to help them settle in, otherwise it would be used on children during their first few weeks at boarding school. It isn’t really to manage difficult behaviour, otherwise the same drugs would be used on half the prison population, but no – these nasty, deadly drugs are only being mis-prescribed to the elderly. So Paul Burstow is right when he states that the chemical management of older people is a scandal.
I make no apologies for once more making the point that people like Edzard Ernst, who spend so much time atacking complementary medicine or trying to damn it with faint praise say nothing – NOTHING – about things like this, even though Ernst used to be actively involved in the work of the Medicines and Healthcare Regulatory Agency! No, conventional medicine and general practitioners can kill as many people as they like, that’s fine by Ernst. But he’ll be very quick to warn you about things like acupuncture or homoeopathy… as if that is where the danger lies!
This is just one of many examples that prove that the overall drive is to medicate, medicate, medicate. Not all doctors are pill happy but too many clearly are, and it is now killing people in vast numbers but for some really scary reason, the trend is to prescribe even more despite that, and the guidelines, well… they might as well be in the bin.