Is the time ripe for MadinAmerica readers to organize legislative action to curb the use of drugs as chemical restraints? Recent developments in Congress, in the state of Washington, and in California suggest that the answer is yes.
In California, the state Senate voted unanimously this month to enact a package of four reform bills to reduce the use of antipsychotics and other psychotropic medications to control the behavior of children in foster care. If approved in the state Assembly and signed by Governor Jerry Brown, the legislation will be the nation’s most far-reaching effort to reverse the trend of the past 15 years. That trend has been an ever-increasing use of drugs to control children in foster care, especially those in congregate care, i.e., “group homes.”
Simultaneously, California’s social services and health services agencies are preparing to adopt new policies that should implement the legislation at the ground level, county by county. Already, as of October 2014, the Department of Health Services has implemented a “prior authorization” policy for antipsychotics. Prescriptions for antipsychotics to be administered to foster children and youth now must be approved by pharmacists at the state agency.
The State of Washington has moved in a similar direction, enacting House Bill 1879, which was signed by its governor on May 18, 2015.
Little Open Opposition: What it Signals
Perhaps the most significant feature of the California actions has been that during the Senate’s consideration of the proposed legislation there was no open opposition from the interest groups that have blocked past efforts in California and other states.
For example, organized medicine, represented by the same lobbyists who represent a major pharmaceutical manufacturer, easily squelched a similar legislative effort in Georgia a few years ago. In 2015, in California, the same groups had the same reasons to protect their interests. Instead, they remained largely silent, on the sidelines, perhaps because they saw that the tide was running against chemical restraints. As King Canute knew, it is wiser to watch from the shore than to try to hold back the tide. The absence of open opposition to the California legislation and its approval by unanimous vote in the Senate may be a sign that the political tide has turned Organized efforts to curb chemical restraints may now have a chance to succeed.
The Time May be Ripe in Congress, Too
Representative Karen Bass (D-Los Angeles), responding to the California Senate action, told San Jose Mercury-News reporter Karen de Sá, “I know that it will inspire other states. I have no doubt about it. We are going to make sure that we can do the same on a federal level.” Rep. Bass, together with 15 other members of Congress, recently supported the President’s budget request for $250 million to reduce reliance on medications. As described by de Sá, the funds would “fund state programs that reduce psych med use among foster youth by creating programs that more effectively treat trauma.”
In the U.S. Senate, on May 19, Senators Hatch (R-Utah) and Wyden (D-Oregon) of the Committee on Finance held a hearing on congregate care (group homes), where much of the worst misuses of psychotropic medications take place. One of their witnesses, Alexandra Morgan Gruber, testified about the “myriad of medication” she was forced to take.
“At some points, I was so overmedicated that developed a tic in my face. . . . [which] I still have . . . I had no choice . . . the staff administered the medicine . . . if we refused . . . we would be [punished by loss of all privileges]. When I left the group home, the long list of diagnoses . . . were dismissed . . . .”
Time for Action
The time may be ripe for legislative and Congressional action. We will know that the time was ripe if Mad In America readers and others engage now in successful reform efforts.
For information on what you can do, contact us: [email protected]
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.