Facing down rape: Women stand up to say they are not ashamed


First in a series of posts about the value, importance and  power of owning and  telling our story – and being heard.

Science may think it has all the clever tricks to understand the universe and what we are to make of it but the simple human practices of telling stories and hearing each other as we share ours can offer much more – the ability to connect the dots, recognize complexity and interconnectedness,   and make sense of our experiences – and can play an important role in helping us heal and grow.  

Maybe, one day, scientists will get smart enough to catch up with the rest of us.

This story is about women who are telling their stories of having being raped and standing up to say they are not ashamed. Indeed they have no reason to be ashamed – nor does anyone who has had that experience. The stories tell of their struggles, to overcome not only the experience and the event itself but  experience and the humiliation of being silenced in a society that in small or large part does not know how to deal with violence of any kind let alone violence by men against women and, still, in small or large measure blames women for having being raped. These stories show us how sometimes the struggles to be heard is harder overcome than the experience itself –  one tells of  having to have a court imposed reporting ban overturned so she could tell her story and have newspapers report it.

Telling our story is one way of not only making sense of what happened to us but of showing the world we are not ashamed.  

Facing down rape: Women stand up to say they are not ashamed

Toronto Star, Wed Apr 16 2014
By: Dianne Rinehart Book Reporter, Published onRaped women are standing up to say they are not ashamed — nor will they be shamed.
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karyn_freedman.jpg.size.xxlarge.letterboxKaryn Freedman’s book, One Hour in Paris, which documents her rape at the age of 22 and argues that victims need to speak out to fight against a rape culture, comes out.
Photo TOStar/Colin McConnell

Karyn Freedman is lying on a mat on the floor, trying to pull an enormous imaginary knife away from her throat.

It is part of the therapy she has undergone since being raped at knifepoint in Paris in 1990 when she was 22 by the roommate of a friend’s university instructor.

In real life, she couldn’t escape her attacker but in therapy she regains her sense of personal power by defeating the rapist. In this session, she puts on boxing gloves so she can grab the imaginary knife without shredding her hands. She can escape — if only in her mind — decades after she was held captive.

Confronting her fears is emotionally draining work. Since the attack, she has sought out a number of methods to get her past the post traumatic stress disorder that leads to panic attacks.

one hour in parisHer latest method is going public. She is doing so in her book One Hour in Paris.

While it may seem antithetical, it’s a method that is gaining popularity. Millions of women who have been raped are coming forward to share the horrific details of the assaults, and organizations are springing up to help them share their stories.

“Coming out as a rape survivor can go a long way toward erasing the humiliation that comes with having your body used sexually, violently, against your will,” Freedman writes.

“It is a way of telling the rest of the world that you have nothing to be ashamed of,” says the Torontonian, who is an associate professor of philosophy at the University of Guelph.

Telling her story she says, “helps me feel whole. I don’t feel like there’s something I have to hide. I have found it to be a very important part of my personal recovery.”
For Freedman, the personal is also the political.

One Hour in Paris, a graphic account of her repeated rape and long road to recovery (on sale April 23), also examines the political and philosophical issues behind rape.
“Sexual violence remains a dirty secret,” Freedman writes in the prologue. “Through statistics we may know of rape’s pervasiveness … — one in three women worldwide, one every 10 seconds — (yet) the social and cultural pressure on women to keep their stories private is, for many, an insurmountable hurdle. As a result, survivors of sexual violence remain anonymous, effectively closeted,” she says. “This is deeply regrettable.

It both reinforces the shame that we struggle against and widens the gap between who we are and how others see us.

“This also has the unfortunate consequence of making rape look like a personal problem, a random event that happened to me, for instance,” she says, “because of where I was, what I was wearing, or who I was with, instead of what it really is: an epidemic faced by women and children worldwide which is the manifestation of age-old structural inequalities which persist between men and women. By speaking out about their experiences of sexual violence, survivors can help us to see the problem of rape as a problem of social justice.”

Janet Goldblatt Holmes, 61, agrees.

The former Torontonian also battled her fear and shame before finally writing about being raped on a date when she was 16 and coming out publicly.

Goldblatt Holmes wrote about her experience in 2006 in a survey on the website of The Voices and Faces Project.

More than 400 women and a few men have filled out the survey for the organization, says Katie Feifer, the research director of the organization working to put a face to rape by telling victims’ stories.

“We believe our archive is the largest single repository of survivor testimony in the U.S.”

Goldblatt Holmes found comfort speaking at schools in Toronto and Barrie to help students understand “that no is no” and, if you have been raped, “you have nothing to feel shame about.”

But changing attitudes isn’t easy. Goldblatt Holmes was shocked when a physical education teacher asked her what she had been wearing when she was raped. “It doesn’t really matter what I was wearing,” she told him, though it was simply jeans and a T-shirt.

That attitude — what were you wearing, were you drinking? — is where Freeman and Goldblatt Holmes face a backlash. Blaming women for their own rape disputes the notion that there is a rape culture or that rape is a result of social inequality — and it is being spearheaded, ironically, by other women.

Powerful women.
Journalist Emily Yoffe wrote in Slate that college women should stop getting drunk if they want to avoid rape.

Heather Macdonald, a researcher at the Manhattan Institute, so infuriated listeners in a debate on CBC Radio’s Q, when she denied the existence of rape culture and questioned rape statistics, that the item producer, Julie Crysler, felt compelled to place an editorial online defending their decision to select Macdonald to debate the issue.
Among Macdonald’s points: parents wouldn’t send their daughters to university if rape was as prevalent as contended.

Despite shocking statistics — Statistics Canada’s most recent report found one in five Canadian women have experienced at least one incident of a sexual attack by a date or boyfriend — and recent media coverage of rape chants on Canadian university campuses and university hockey teams being suspended after allegations of sexual assault criticism of anyone discussing rape culture is mounting.

“I think we’re in the middle of a pretty profound backlash right now,” says Lise Gotell, chair of the University of Alberta’s department of women’s and gender studies, who debated Macdonald on Q. “The whole rape culture as feminist hysteria is being spun not only by Macdonald … but by a Time magazine article by Caroline Kitchens that “an out-of-control lobby” for poisoning the minds of young women and creating hostile environments for innocent males.

Gotell couldn’t disagree more: “It’s actually pretty difficult to speak out and identify yourself as a victim of sexual assault.”

Which makes it all the more remarkable that Freedman and others are choosing now to come forward.

Zerlina Maxwell, who was raped by her boyfriend’s roommate eight years ago, responded to Kitchens’ claims with her own essayin Time. The first thing Maxwell heard when she reported her rape to someone she trusted, was “You were drinking, what did you expect.” She created the Twitter hashtag: #RapeCultureIsWhen to counteract the backlash.

Some of the tweets with that hashtag:

    • Rape culture is when women who come forward are questioned about what they were wearing.
    • Rape culture is when survivors who come forward are asked, ‘Were you drinking?’
    • Rape culture is when people say, ‘she was asking for it’

Ironically, the most controversial argument Maxwell is being attacked for is her assertion that the most effective way of preventing rape is to educate potential perpetrators.

That stand has garnered her appearances on television shows and a feature in Glamour magazine as one of the faces of “a new generation of women who are taking the fight for justice into their own hands.” Among those featured, was Savannah Dietrich, who had been sexually abused by two athletes. They were found guilty and convicted, but when she found out if she spoke out about the case she could get 180 days in jail she tweeted: “Will Fray and Austin Zehnder sexually assaulted me. There you go, lock me up. I’m not protecting anyone who made my life a living hell.”

That’s the stand two Toronto women took after they were sexually assaulted on the operating table by Dr. George Doodnaught.

Both Debra Dreise, 43, and Eli Brooks, 56, went to court to get the publication ban on their identities lifted so they could speak out.

“I am not ashamed. These are crimes that happened to us,” Dreise told the Star in March. “I want to empower and encourage any other victim of any other crime not to be ashamed and do the right thing no matter what the social status of the perpetrator is, a policeman, a doctor, a teacher,” she said. “Take a stand and do not be intimidated.” As more women go public, their actions encourage others.

The One Billion Rising for Justice campaign launched by The Vagina Monologues author Eve Ensler, asks survivors “to break the silence and release their stories — politically, spiritually, outrageously — through art, dance, marches, ritual, song, spoken word, testimonies and whatever feels right.

The movement grew out of her V-Day movement to end violence against women.
Meanwhile the United Nations has launched Unite to End Violence Against Women. Its “Voices of Survivors” program allows victims of violence to speak about the assaults in their own words.

“What they’re trying to do,” Freedman says of all these movements, “is to promote international global awareness about rape and sexual violence by putting names and faces (to the issue), which I think is a really important move both for reasons of healing and also for political reasons.”

As the debate rages, Freedman is finally looking forward, not backward — and it’s to “the fresh faced young women and men” she sees on campus. “I imagine I will be a potential resource for students,” she says. “I really think we’re failing young women and young men on college campuses. We’re failing them both by not having a more organized national and international strategy for dealing with rape on college campuses … I hope to be put in a position where I can effect change and help to do something about this problem.”

Original article

Related

As more women go public, their actions encourage others…

  • One Billion Rising
  • The Vagina Monologues Eve Ensler, asks survivors “to break the silence and release their stories — politically, spiritually, outrageously — through art, dance, marches, ritual, song, spoken word, testimonies and whatever feels right.

 

Posted in adversity, power, trauma | Tagged , , , , , | 6 Comments

I just want to be me – Small Potatoes


Small-Potatoes

boom da boom da boom da boom
da da da boom

badoom boom boom…

I think punk rock is somewhere like where the really cool people like do their own style of music…

one! two! three! four!

 

Posted in a little bit mad, emancipate yourself..., manamana, music | Tagged , | Leave a comment

breathing light – Nitin Sawhney


Posted in music | Tagged | Leave a comment

Canadian Government has a serious drug problem


Not the one you might have  seen on the late night talk show circuit  but the one that has Canada’s Prisons Services routinely drugging 65% of women inmates and Ontario’s  Long Term Care homes routinely drugging up to 70% of elders and seniors to subdue and restrain them.

A CBC report on a joint investigation with Canadian Press shows how Canadian prisons have become  a “drug-infused world where inmates are routinely prescribed powerful drugs licensed to treat serious conditions but used in Canadian jails as a sleep aid”.

It seems far easier to give someone a prescription than, well, anything…


drugging women“Seroquel is known as ‘the sleeping pill’ in the prison system.
It seems far easier to give someone a prescription than help them address past trauma or help them find a better way to manage their time”

 

 

Two out of every three


drugging women 2
Two out of every three women in Canadian Federal Prisons use psychotropic drugs.

 

 

 

Oh Canada!
This might be somebody’s  version of “Peace, Order and…”
but its surely not “Good Government”.

 

Strombo, dear Strombo, the answer is “yes”.

strombo

Do Canadian Prisons And Nursing Homes Have A Prescription Drug Problem?

APRIL 15, 2014

(Photo: PHILIPPE HUGUEN/AFP/Getty Images)

According to two major news reports released this week, Canadians in various institutions are being given powerful drugs they might not need.

A joint CBC News and Canadian Press investigation revealed that mood-altering drugs were being given to female inmates in Canadian prisons at an alarming rate, for purposes other than what the drugs are typically prescribed for — “raising concerns the drug was being used to ‘subdue’ or ‘sedate’ inmates.” Prescribing practices at Correctional Service Canada are now under review.

One of the major concerns of the investigation is a drug called quetiapine, or Seroquel as it’s more commonly known. The drug is prescribed for treating bi-polar disorder and schizophrenia, but the investigation revealed it’s often handed out off-label (that is, for uses other than the drugs are approved for) as a sleep aid.

“That’s just bad medicine,” said Dr. David Juurlink, head of clinical pharmacology and toxicology at Sunnybrook Health Sciences Centre in Toronto. “These are drugs that used even in the right indications, have side effects that can be lethal. [Quetiapine] is an anti-psychotic drug, and when it’s used indiscriminately it can kill people.”

A 2008 report by the University of Ottawa claimed that quetiapine was used wrongly in prisons for years. CBC News and the Canadian Press obtained an internal memo from Correctional Services Canada that shows the drug was given to inmates for unapproved purposes until at least 2011. And quetiamine is just one drug currently in question. The investigation also revealed that prescriptions of psychotropic drugs in general — that is, drugs that affect brain function and alter moods and behaviour — are increasing among female inmates. In 2013, 63 per cent of female prisoners were prescribed a psychotropic drug.

Correctional Services Canada responded to CBC News and the Canadian Press in a statement, saying: “As part of our ongoing process of quality improvement, medications provided by CSC are regularly reviewed and additional criteria are occasionally put in place. Effective June 2011, quetiapine was listed with limited use criteria to further ensure its safe use. CSC respects Health Canada’s standards when providing prescription medications to inmates.”

Watch the CBC News The National report here:

Posted in sh!t is f#cked, what's going on?, what's up, doc? | Tagged , , , , , , , , , , | 1 Comment

drugging seniors in “long term care” – Ontario


Toronto Star again, this time shining a light on the prevalence of using potentially deadly drugs to restrain  seniors in care homes.

“Ontario nursing homes are drugging helpless seniors at an alarming rate with powerful antipsychotic drugs, despite warnings that the medications can kill elderly patients suffering from dementia.”

Q. So  this what Ontario means by  “Health and Long Term Care”?

In some homes as many as 74% of  residents are routinely  prescribed powerful and risky drugs like “antipsychotics”  - so that staff can have an easier day.

This despite these drugs not being approved for dementia and carrying very clear warnings when used with elderly and dementia, exactly the use that is becoming so prevalent….

“Elderly patients with dementia treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo”

The eagle-eyed amongst you you may also notice that many of the drugs being used to restrain seniors are also on the list of prescription drugs reported to be under safety investigations by Canada Health.

It looks to me a lot like institutionalized drug and elder abuse.

Ministry-of-Truth

You may well be, as am I,  wondering what  George Orwell might have  made of calling this “healthcare.”

 

      ___________________________________________________________

Toronto Star, Tue Apr 15, 2014

Use of antipsychotics soaring at Ontario nursing homes

By: David Bruser News Reporter, Jesse McLean Investigative News reporter, Andrew Bailey Data Analyst,

Powerful, potentially lethal drugs are used off-label to control behaviour among dementia patients at alarming rates in some homes.

Ontario nursing homes are drugging helpless seniors at an alarming rate with powerful antipsychotic drugs, despite warnings that the medications can kill elderly patients suffering from dementia.

A Star investigation has found that some long-term care homes, often struggling with staffing shortages, are routinely doling out these risky drugs to calm and “restrain” wandering, agitated and sometimes aggressive patients. At more than 40 homes across the province, roughly half the residents are on the drugs. At close to 300 homes, more than a third of the residents are on the drugs.

image001.JPG“Leisureworld” on St. George St. has 67 per cent of its residents – 160 of the home’s 238 beds – on antipsychotics, according to nursing home data obtained by the Star.

The medications — including olanzapine, quetiapine and at least 10 others — are not approved by Health Canada for the elderly with dementia. Pharmaceutical companies have issued the strongest possible caution, known as a black-box warning, on their labelling.

“Elderly patients with dementia treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo,” the warning says, adding that these patients face a 60 per cent increased risk of death compared with similar patients who are not taking these drugs.

Family members, doctors, and in one case the provincial coroner believe that prescriptions for these drugs have contributed to the deaths of Ontario seniors with dementia.

Ethel Geraldine Anderson, known to some relatives as “Aunt Gerry,” died after being given increasing doses of Zyprexa at a Wellesley St. nursing home. Her widower, Clayton, says he was never informed about the drug’s potentially lethal effects on people with dementia, and wouldn’t have consented to its use.

Ethel Geraldine Anderson, known to some relatives as “Aunt Gerry,” died after being given increasing doses of Zyprexa at a Wellesley St. nursing home. Her widower, Clayton, says he was never informed about the drug’s potentially lethal effects on people with dementia, and wouldn’t have consented to its use.

Ethel Geraldine Anderson — known as Aunt Gerry to her loved ones — is among such cases. Anderson’s niece told the Star “they tried to quiet her down” with doses of olanzapine in the Wellesley St. nursing home where she was living. Four months later, she was dead.

Elm Grove nursing home in Parkdale, a 126-bed facility, gives 56 per cent of its residents antipsychotics.

At a home in Bourget, a quaint village east of Ottawa, 73 per cent of the residents are being prescribed the drugs.

And at Woodland Villa, another home near Ottawa, 65 per cent of residents are on antipsychotics. Pat McCarthy, the CEO of the company that owns the home and two others with high rates, said a nurse shortage has contributed to an over-reliance on drugs to handle elderly patients with dementia.

“The numbers make me ill,” said Liberal MPP Donna Cansfield, who has called on her party’s government to review the use of antipsychotics in Ontario’s nursing homes. “It’s wrong. I think it’s too high. I’m very concerned. We have a problem; we need to deal with it. That’s our responsibility as government.”

The province tracks the number of residents on these pills home by home, but much of this information hasn’t been publicly reported, the health ministry said.

Cansfield spent months working back channels at Queen’s Park to obtain the data, which she shared with the Star after raising the issue with Premier Kathleen Wynne and Health Minister Deb Matthews. She says officials have acknowledged the problem but she has seen no action yet.

When antipsychotics are prescribed to seniors with dementia, it’s known as “off-label” use, meaning a drug is being used for a condition or age group for which it hasn’t been approved. It’s legal for doctors to do this, and they do so with little oversight.

“These medications are being used as a routine, when they are extremely powerful and are not proven to work for seniors. It’s very scary,” said Jane Meadus, a lawyer at the Advocate Centre for the Elderly, a community legal clinic for low-income seniors. “They (can) have horrible side effects on people, and they may in fact cause the very symptoms that they are supposed to be eradicating: violence and confusion.”

While some residents in Ontario long-term care homes may suffer from schizophrenia, bipolar disorder or another condition that antipsychotics are approved to treat, most — 63 per cent — suffer from dementia. At Golden Plough Lodge in Cobourg, more than 90 per cent of residents have some form of dementia.

A Star analysis of the data found that there are thousands of seniors on potentially dangerous medications not approved for their condition.

In one case, an 85-year-old woman with dementia was on risperidone and other druges to help control her wandering — an off-label use — in a long-term care home when she took a bad fall and died. (Risperidone is approved to treat only dementia patients with severe psychosis or aggression.) The Ontario coroner’s office said the drugs she was inappropriately prescribed played a role.

Among other Canadian cases, the Star found reports of side-effects that do not specify where the deaths occurred.
In one case where clozapine was prescribed to a 70-year-old man with dementia, the result, according to the doctor who filed the side-effect report, was death.

A man died after he was prescribed quetiapine for dementia, and the 2012 side-effect report listed the reactions to the medication: “Off label use. Cardiac failure.”

In 2012, a doctor prescribed olanzapine to an 81-year-old woman for “patient restraint.” She suffered a stroke, fell and died. The report cited the “off-label use” of the drug.

As part of a lawsuit filed in Alberta, a court was told in 2009 that a 61-year-old Alberta woman with Alzheimer’s disease was prescribed an antipsychotic as a “chemical restraint.” She died from what the coroner found to be an allergic reaction to olanzapine.

Nursing homes are required to obtain “informed consent” from patients or their substitute decision-makers before prescribing antipsychotics. Ethel Anderson’s husband said doctors never got his consent to administer olanzapine, which was backed up by a subsequent investigation.
MPP Donna Cansfield wonders how many prescriptions are written without the consent of residents’ families or a full understanding of the risks.

“Are (families) made aware of other (treatments) or are they simply told, ‘Grandpa is agitated and the only way we can calm that agitation is with the use of a drug?’”

The provincial College of Physicians and Surgeons will not say if the doctor in charge of Anderson’s care was cautioned or ordered to undergo retraining.

Statistics obtained by the Star show antipsychotic use rates at 631 nursing homes in the first half of 2013 averaged 33 per cent.

That’s more than twice the rate found in a recent U.S. review that resulted in a call for change. The U.S. probe of Medicare prescriptions found 14 per cent of elderly nursing home residents had claims for atypical antipsychotic drugs. The office of the Inspector General, whose mission is to deter waste and abuse, declared the ssprevalence of these “unnecessary drugs” was too high and recommended the federal government fix the problem.

Serious aggression and extreme violence are not unknown in Ontario nursing homes. In November, an 87-year-old resident of a Scarborough nursing home was beaten to death; his 81-year-old roommate was charged with second-degree murder.

Despite the risks, antipsychotic medications can be an effective treatment for patients who have severe aggression, agitation or hallucinations caused by dementia — symptoms that make the resident a danger to himself and others.

Clinical guidelines do recommend risperidone and the off-label use of olanzapine and a drug called Abilify in “severe” cases of dementia-related behavior.

“The potential benefit of all antipsychotics must be weighed against the significant risks such as cerebrovascular adverse events and mortality,” the guidelines say.

However, one expert estimates that only 10 to 15 per cent of dementia patients suffer such severe problems, suggesting that far more residents than necessary are being put on the drugs.

“There is a role for these medications, but probably not at the rate that they’re routinely prescribed in nursing homes,” said Dr. Dallas Seitz, a geriatric psychiatrist and professor at Queen’s University.

At Miramichi Lodge in Pembroke — a 166-bed facility where more than half of the residents are on antipsychotics, according to the data — managers say 30 of their residents have dementia and are on the popular drugs “as a last resort” to treat aggressive behavior.

When taken by patients with dementia, the risks of fatal side-effects such as heart attack are significant enough to justify the drug companies’ black-box warning.

More common side effects, which drug safety experts say can have a devastating impact on fragile and vulnerable seniors, include falls, sedation and movement disorders.

Several homes with high rates told the Star they are trying to get their prescribing rates down. Where possible, they want to devote resources to “behavioural” therapies, whereby caregivers are trained to identify and neutralize what triggers agitation in residents with dementia. Triggers may include hunger or physical contact in common living areas.

At Revera Inc., which owns more than 50 homes and had an average antipsychotic prescribing rate of 35 per cent in the first half of last year, executive Joanne Dykeman says staff have focused on treating without drugs. The prescribing rate has gone down several percentage points companywide.

Some homes say they do not have the resources for the training and new hires often needed for more intensive, time-consuming therapy.

At Maple Villa Long Term Care Centre in Burlington, where the antipsychotic prescribing rate was 57.5 per cent in the first half of 2013, administrator Barb Goetz acknowledged, “We are above the provincial average by far.”

But she added that her home’s current internal data show only 45 per cent of residents are on the drugs, and one-third of those are medicated for “behavioral management.”

“I’d like to think it’s going to decrease, but to be realistic, I don’t know,” Goetz said. “Some people will say to us, ‘Can’t you just do a one-on-one with people when they’re being aggressive?’ We don’t have the funds to do that.”

The Ontario government has poured millions of dollars into hiring and training front-line workers to provide better care for residents with dementia and mental health issues.
After a 2011 Star investigation into widespread abuse and neglect in Ontario nursing homes, the government spent $59 million to hire more than 600 employees and train 34,000.

The efforts appear to have done little to ease most nursing homes’ reliance on these powerful drugs for managing troubled residents’ behaviour.
“We’ve been advocating for more resources, for more skilled staff, more training. We think it’s very timely for the ministry to make this investment,” said Candace Chartier, CEO of the nursing home association, adding that a “behavioural support” team should be in every home.

At Leisureworld, the St. George St. home that, at 67 per cent, had Toronto’s highest rate of antipsychotic use, managers said a main reason for it is beyond their control.

Marg Toni, a Leisureworld vice president, said many new elderly residents come to the home already on antipsychotics prescribed by a family or hospital doctor — a point underscored by managers at other homes. “We have been diligently working on reducing the use of these medications,” Poni said.

Poni added that her Leisureworld home is “atypical” because many of her residents aren’t actually seniors; they’re people under 65 who have been diagnosed with mental health issues but have nowhere else to go.
Leisureworld St. George is one of five homes in Toronto with prescribing rates at 50 per cent or higher.

A 2007 study found people living in nursing homes with high prescribing rates were three times more likely to be dispensed an antipsychotic than those in other homes.

“What’s . . . available and acceptable to clinicians is medications, which may not be the best thing for the resident but may be the only thing easily available,” said geriatric psychiatrist Dr. Seitz.

“We know it’s high,” said the director of care at Residence Champlain in eastern Ontario, where antipsychotic use is 67 per cent. “We’re working hard. We know there’s some side effects. We know it’s not the best medication for (some) residents. We know we need to be careful. We need to have our number as low as possible.”

Caressant Care — the company that owns a nursing home in Bourget where 73 per cent of the residents were on antipsychotics in the first half of 2013 — says staff perform in-depth reviews to ensure medications are appropriately prescribed. The company said it is in favor of more funding for behavioral therapies for seniors with dementia.

The health ministry told the Star: “Improvements have been achieved . . . but more needs to be done and the ministry continues to work with the (long-term care) sector to identify strategies to provide quality, safe and appropriate care” to residents.

David Bruser can be reached at 416-869-4282 or at dbruser@thestar.ca

Original at 

http://www.thestar.com/news/canada/2014/04/15/use_of_antipsychotics_soaring_at_ontario_nursing_homes.html#

Posted in anatomy of an epidemic, learn about your medications, Psychiatry | Tagged , , , , | Leave a comment

151 Prescription drugs under safety investigation in Canada


Toronto Star has published a list of 151 prescription drugs undergoing safety investigations in 2o13. The Star obtained the information only after persistently bugging officials at Health Canada.

With a remarkable example of doublespeak, up till now Canada’s drug safety authority though the best way to keep us safe was to keep this information secret from both the individuals who put these drugs  in their bodies and from the Doctors who prescribe them.

Quite why Health Canada ever thought this was their role is yours to guess and ask. Maybe they reasoned that the mass panic ensuing from making the information available would cause us all to ask for motte drugs in such a rush that Docs would run out of prescription pads.

Congratulations to The Star team working on this and also to Health Canada for living up to their name and making available important information information like this so that individuals and their Doctors can have the information they need to make better informed choices about using drugs.

There is no compelling argument to be made against transparency when clinical decisions and patient safety hang in the balance,”

-Dr. Juurlink,  Sunnybrook.

 You’ll find many prescription medications on the list – including the commonly prescribed ones. if you take meds then you might find one of your meds on the list.

Note- Just because a drug is on the list and  under investigation does not mean it’s more dangerous than one that isn’t . It does, though, mean it’s  a good idea you find out more about the drugs you take and talking with your Doc about what it means for you.

ideaAn Idea…

Why not take a copy of the list to your Doc or other workers next time you see them?http://www.scribd.com/doc/217732071/Drug-Safety-Reviews

You can also get a report that lists adverse reactions reported for each of the drugs you take from RxISK.com

_____________________________________________

Article…

Star obtains list of red-flagged drugs

By: Diana Zlomislic News reporter, Published on Sat Apr 12 2014

Doctors and health experts alarmed that Health Canada won’t make public its reviews of drug investigations in 2013.

quietepine seroquel.jpg.size.xxlarge.promoQuetiapine, known by the brand name Seroquel, is the top-selling, most prescribed antipsychotic in Canada, ringing in sales last year exceeding $200 million. Indicated to treat schizophrenia and bipolar disorder, researchers say the spending figures suggest the drug is still being used widely off-label to sedate elderly patients with dementia despite warnings against this practice.

Top-selling antidepressants, sleep aids and diabetes drugs are among 151 secret safety reviews of medications completed by Health Canada last year, the Toronto Star has learned.
The Star obtained a list of last year’s federal drug reviews that likely won’t see the light of day despite Ottawa’s new commitment to transparency. It took repeated requests made over five months to access the index. No public record of this work has existed until now.
The Star shared this list with half a dozen doctors at hospitals and respected drug safety and health policy researchers, all of whom were troubled that Health Canada has no plans to publish reviews associated with many high-profile medications.
The index includes reviews of brand-name pills like Seroquel, an antipsychotic. Intended primarily for the treatment of schizophrenia and bipolar disorders, it accounts for more than 40 per cent of prescriptions in its drug class, with sales exceeding $200 million annually (a figure that suggests it’s frequently used outside its approved purpose). Also scrutinized were asthma inhalers (Alvesco and Qvar), painkillers (Tridural and Tramacet) and the smoking-cessation drug Champix, which reportedly was linked to suicides in some users though Health Canada ruled last year that the drug’s benefits continue to outweigh its risks.
The federal index also shows government officials had cause to investigate entire classes of drugs, including ones used to treat cancer, anxiety and severe mental health disorders though exactly what Health Canada found in these reviews is largely a mystery.
In many cases, doctors who prescribe these drugs and the Canadians who take them have no idea the medications were even under investigation, red-flagged because of concerns raised by regulators in other countries or because of worrisome side effects detected during Ottawa’s routine monitoring.
“Millions of people take these drugs,” said Dr. David Juurlink, a physician at Sunnybrook Hospital and a former pharmacist. “These drugs harm people and in some instances they kill people. Frankly, shame on them for even contemplating not publishing them.”
A medication called Keppra, used for seizures in adults and children, was reviewed by Health Canada three times last year yet the federal online database that physicians and patients rely on for details about adverse drug reactions and recalls includes no mention of it at all. A more general search of the federal website reveals the product monograph was updated in September 2013 to include a “brand safety update” for “drug interactions” but there is no additional information.

Health Canada’s new plan to be less secretive comes with a few catches.
Only a fraction of all drug reviews completed by Health Canada will be publicly released. Those that are shareable will appear on the department’s website in summary form. While full reviews of summary reports will be available for the asking from Health Canada’s Marketed Health Products Directorate, portions of those documents may be blacked out to protect confidential business information from manufacturers or other regulators. And reviews will be released only on a “forward-going basis.” Assessments completed before 2014 will be shared only if there is a great public interest. Problem is, Canadians have virtually no way of knowing what assessments are worth fighting to make public.
“It’s just really an issue about the amount of resources it takes to put together these summaries and to make them available,” federal Health Minister Rona Ambrose told the Star, explaining why drug reviews completed before 2014 are not part of the transparency plan.
During a stop in Toronto earlier this week to visit St. Joseph’s Health Center, Ambrose told the Star she was unaware that an annual list of drug reviews completed by Health Canada wasn’t publicly available.
“We will look into that,” she said. “If the lists are not available, I will ask the department why that is the case. The commitment they’ve made to me is to support this level of transparency. We will continue to endeavour to be more and more transparent. We want to hear feedback from people,” she said.
“There is no compelling argument to be made against transparency when clinical decisions and patient safety hang in the balance,” said Dr. Juurlink of Sunnybrook.
“I can see how redacting and summarizing information from these reports could get expensive but that is money Health Canada should be spending,” said Dr. Joel Lexchin, an emergency physician with University Health Network in Toronto and a professor in the School of Health Policy and Management at York University.
The government’s first public release of a drug review — a summary report for Diane-35 posted online earlier this week — is an exception. A review for the controversial acne pill, widely used off label for birth control, was completed last week.
Ambrose made the promise to begin releasing drug review reports four days after the Star published its first investigation into Diane-35 last October, featuring the case of first-year University of Calgary student Marit McKenzie, 18, who died suddenly in January 2013 from complications caused by a massive blood clot. A hospital pharmacist suspected Diane-35.
McKenzie was the 13th young Canadian women whose death was linked to the drug according to adverse reaction reports filed with the federal regulator, though the associations have not been proven. Health Canada refused to publish its safety review of Diane-35 despite requests from the Star and the family to do so.
It’s no secret that one of the 10 most-prescribed classes of medications in Canada has some issues.
Benzodiazepines, often called “benzos,” are a sedative-hypnotic group of drugs that treat anxiety and insomnia.
“They’re always on a watch list of drugs you should look out for for potentially inappropriate use,” said Steve Morgan, a University of British Columbia health economist who co-authors the Canadian Rx Atlas, an online compendium that analyses drug use and spending for more than 10,000 medications using data supplied by health-care market research company IMS Brogan.
Canadian doctors wrote more than 20 million prescriptions for benzos last year. Sixty-three per cent of the $336 million spent on these drugs in 2012-2013 was attributed to female patients. Bestselling generics include lorazepam, zopiclone and oxazepam.
“Long-term use carries significant risk of addiction, dizziness and falls,” Morgan said. “It becomes difficult to wean patients off. They’re a problematic drug class.”
Also re-evaluated in 2013 for unclear reasons is an entire group of cancer drugs known as Vascular Endothelial Growth Factor Inhibitors.
They prevent the growth of blood vessels that supply the tumour with nutrients to grow.
The most commonly used drugs assessed in that category are bevacizumab (for colorectal cancer, brain cancer, cervical cancer) and sunitinib (for renal cell cancer, pancreatic cancer, sarcoma), a spokeswoman for BC Cancer Care told the Star. She said the agency was not aware of any specific safety reviews completed by Health Canada.
In the case of sunitinib, Health Canada issued an advisory last September warning that the drug could cause “severe and sometimes life-threatening skin rashes.”
Health Canada conducts several types of drug reviews. The largest category is routine monitoring that relies on “proprietary” information provided by manufacturers about adverse reactions, usage data and risk-management plans. In 2013, the federal health department reviewed 128 drugs in this way.
Dr. Supriya Sharma, a senior medical adviser with Health Canada, told the Star that this group of reviews is exempt from public release unless officials find something alarming that prompts a more comprehensive safety review.
These routine reviews are just point-in-time snapshots of a drug’s performance on the market, Sharma said, and Health Canada worries the information could be taken out of context.
“This argument about information being taken out of context can be used to justify withholding almost anything,” said Lexchin. “If Health Canada is worried about that, they can contextualize the information by pointing out what its limits are.”
The names of 47 of the 128 drugs subject to routine reviews last year were withheld entirely from the list provided to the Star because these drugs are awaiting approval and Health Canada has agreed not to identify them.
This is also a problem, Lexchin said. “Some of these drugs they’re considering for approval are similar to things that are already on the market that have problems. Some of them may be drugs that they’ve previously rejected and now are reconsidering again. Why are they doing that? What’s changed? There are a number of reasons for wanting to know what they’re thinking about.”
Drug safety researchers and doctors say it’s unreasonable to expect that federal health officials can spot every early sign of trouble all on their own. While some of the drugs on last year’s routine-monitoring list included well-known entities like Avandia — once the world’s bestselling treatment for Type 2 diabetes before it was removed from the European market in 2010 over concerns about its potential to cause heart and strokes — a number of the medications are new to the market.
For this latter group in particular, a second-set of eyes on emerging data is critical, said Lexchin.
“Based on the work I’ve done, the most dangerous period for new drugs is within the first three years,” said Lexchin, who has been published extensively in peer-reviewed journals on the topics of drug safety and prescribing practices. “Anything that’s been on the market three years or less, we should get as much safety information as there is.
“They’re not going to catch everything. Some of these issues around how well drugs work or how safe they are involves interpretation. We need to be able to know what’s going on to be sure Health Canada is making appropriate decisions.”
A case in point: Long before Vioxx came under public scrutiny, a critical, secondary review of published FDA data on the painkiller warned about dangerous side effects, including severe heart problems. This assessment was carried out by researchers at University of British Columbia’s Therapeutics Initiative. Three years after Vioxx hit the market, their work revealed evidence of an increase in heart attacks and other serious side effects associated with the drug. As a result, British Columbia’s Ministry of Health decided not to fund the drug. Two years later, Vioxx was suspected of causing tens of thousands of fatalities across North America. The independent review of Vioxx is credited with saving more than 500 lives in British Columbia.

The list of drugs under investigation in 2013, compiled by Health Canada can be found here…


Original Article at Toroto Star

 

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papering over the cracks in a fractured society


Sort of disclaimer for talk about Psych Meds

Here at recoverynet.ca we believe that medications are not a moral issue.

Taking meds is not a moral issue – no more than not taking meds a moral issue.

For each of us, whether or not we take meds is a choice that is best made by ourselves, hopefully with true informed consent – meaning with full knowledge of all our options and all the effects.

Medications are simply a tool – nothing more and nothing less. Use them to the extent they work for you.  Anyone telling you otherwise is, really,  behaving like a tool- so use them to the extent you find them useful too.

Basically, we believe that anyone who tells you that you should take meds or that you should not take meds should mind their own bloody business, and that’s being as polite as we possibly can.

Enough of all the should-ing alright?

 

The big crack in our society

That said, at a societal level, our current reliance on use of medications raises some serious questions about how we, as a society, create and maintain institutions and services, the options those services provide  and especially those that serve those of us who are less able- financially and otherwise- to serve themselves.

This article from  yesterday’s Guardian focuses on the now widespread use of the class of psychiatric drug known commonly as “anti-depressant” and does a very good job of highlighting the extent that the UK, like many other countries, now relies on drugs to paper over the cracks in a rapidly fragmenting, and increasingly fractured society.

In UK, there are now fifty million prescriptions per year for “anti-depressants” – almost one prescription, per person, per year.

Of course, if you can afford to pay yourself for services then you will always have more options and in time can likely find whatever services work for you.

Meanwhile, those less affluent must rely on publicly provided services and so are inevitably and invariably offered no options beyond taking the pill by choice or being coerced to take the pill -  and a long wait on a long wait list for talk therapies.

In absence of anything else, meds can help – somewhat, for period of some time,  and for some people.

But,  as the examples in the article illustrate there is almost always some connection with the experience of what we might call “mental illness” and the individual’s experience of life.

big crackWould we not do better to adopt approaches that deal with the cracks, the causes of the cracks – and even crack prevention?

Again, as the article states, progress has been made in “reducing stigma” where “stigma” is counted as the embarrassment or shame a person feels that prevents them asking for help- and is addressed by advertising people to come forward to ask for help. Yet what is “stigma” if not the impact of  the way society both discriminates against those who experience struggles and the continued failure to offer at best effective options?

Anti-stigma campaigns can indeed result in more people being persuaded to not struggle alone and to ask for help.  It is tragic that these people then find themselves  are offered little more than the drugs and a long wait on a long wait list, and now find themselves truly marked and separated from the rest of a society and those individuals who have yet to find themselves so marked.

So, the real effect of so called “stigma reduction” is more people taking more drugs so they can hang in there while waiting  for services to get round to offering more than drugs.
No wonder they are called “patient”.

These self congratulatory multimillion dollar advertising campaigns pride themselves for pushing more people into a dependence on drugs. Anti-stigma campaigns are sausage machines – effectively tax-funded advertising that subsidizes the operations of some of the world’s richest corporations.

As the title asks: are we, as a society, using mass drugging to paper over the very evident cracks in our fractured and fragmented society?

And, In doing so, do we not mask the price that millions of individuals -including children- must pay to paper over the cracks in a society that clearly works well for some but leaves the rest of us who have fewer choices taking drugs that might well leave us just comfortably enough numb that we can get through the day minding little enough about the injustice of a society in which a decreasing few increasingly grab all that they can for themselves while the rest of us pay with our health.

 

The Guardian, Sunday 13 April 2014

Are we using antidepressants to paper over the cracks of a fractured society?

Use of antidepressant drugs has become more common than ever before. Perhaps it’s time that we looked at the wider causes of this trend.

Prozac CapsuleMore than 50million prescriptions for antidepressants are written in the UK every year. Photograph: Alamy

The chances are that you know someone who takes antidepressants. Or maybe you take them yourself. If so, you are in good company. More than 50m prescriptions for antidepressants are written in the UK every year and, although not all of the pills will be swallowed – taking into account repeat prescriptions and failure to collect from pharmacies – the figure is still staggeringly high.

There’s a positive side to the 50m statistic, though. It suggests that as the stigma has decreased, people have become more willing to ask for help. And, for many, antidepressants work. However, while professionals are quick to acknowledge the benefits – which can be life-saving – many express concern about our growing dependence.

“Prescription levels have gone through the roof,” says Dr Matthijs Muijen, head of mental health at WHO Europe. “On the demand side, people know antidepressants work. I would even argue there’s a degree of fashion about antidepressants. On the supply side, antidepressants have become cheaper and more easily available. Doctors now know it’s easy and ‘good’ to prescribe.”

Key to arguments around antidepressant use are questions about what constitutes “normal” sadness and where the boundary lies between this and clinical depression. There is no cut-and-dried answer, and this ambivalence around the use of antidepressants seems to be characteristic of those taking them. “It’s not ideal, but I just make use of the resources available,” is a characteristic response.

Lisa Cunningham, 45, was signed off on sick leave and prescribed Prozac after suffering problems at work. Soon afterwards, she was attacked, leaving her with facial injuries and even deeper depression. For nearly 11 years, Lisa remained on medication, becoming steadily more withdrawn, until she barely left the house.

Cunningham’s story has a positive outcome: after being referred to a volunteering scheme by her GP she got involved in a gardening project which led to a full-time job. She then felt able to stop taking her medication. “Antidepressants did a vital job and I definitely think I had clinical depression,” Cunningham says. “But I was a nervous, anxious child.” She explains that while growing up, she was subjected to physical aggression from people close to her, “so it was almost inevitable I’d get depression. Looking back, it would probably have been better if I’d had some sort of psychotherapy in school.”

For Darren Ellis, 40, life events and mental health have been similarly linked. Ellis lost his father at 16 and at the time was not offered any support. Ellis’s depression and anxiety developed and he was prescribed medication after medication. None of the drugs worked and he twice attempted to take his own life. It was only this year that he was able to get the one-to-one cognitive-behavioural therapy (CBT) that, he says, is finally helping him to recover.

Ellis believes things could have been different; that the depression could have been prevented. “I’m sure I could have avoided taking medication if I’d had therapy immediately,” he says. “I was confident – the life and soul of a party – until my dad died.”

The link between life events and depression is of course not disputed, but it is of particular relevance now. A report by The Health and Social Care Information Centre revealed that in many places in the UK – including Barnsley, Durham, Middlesbrough, Redcar, Salford and Sunderland – approximately one in six adults are prescribed antidepressants. By comparison, in affluent Kensington & Chelsea, it is one in 21.

Since the recession began, Mind has reported a dramatic rise in the number of people calling its phone line. “There are clear links between unemployment and depression,” says Sophie Corlett, Mind’s director of external relations. “After six months, one in seven unemployed men will develop mental-health problems. People are falling into debt and there’s a reciprocal relationship between debt and mental health.”

While almost everyone with experience of antidepressants reports finding them useful, many could have made use of alternative forms of help. “We know that people go to the doctor because they’re feeling low, and the reasons may be domestic violence, debt, bereavement, marriage breakup, difficulties from past trauma,” says Corlett. “Some of these are practical and could have practical solutions, while some are deep-rooted psychological issues that need dealing with. Antidepressants are not always the answer.”

For mild to moderate depression, unless it is persistent, the National Institute for Health and Care Excellence (NICE) does not recommend medication as a first resort. However, despite the government’s investment in the Improving Access to Psychological Therapies programme, in some parts of the country people wait months for access to CBT or similar treatments. Likewise, it does not appear that people’s prescriptions are always reviewed every six months, as NICE suggests.

There are many problems with prescribing antidepressants when there could be an alternative solution. Antidepressants have side-effects that we are only just discovering and, although prices have dropped as patents expire, the cost to the NHS is still huge.

It is impossible to gauge whether we live in a more stressful age than that of our grandparents. What is certain is that attitudes and access to drugs have changed. On balance, this is a good thing. But as the economy continues to flounder, the number of people struggling with mental-health issues is likely to increase, almost certainly leading to the writing of yet more prescriptions.

“My worry is that we are medicalising all forms of sadness in the belief that antidepressants are a safe drug that you just prescribe,” says Muijen.

Mind has called for accurate research to be carried out into how many people are taking antidepressants, how long they take them for and whether they are receiving any other treatment. It is a serious problem, Corlett says, that this data does not exist. Antidepressants are a vital tool. But if, in many cases, we are simply papering over cracks, we should, as a society, face up to the depth of the problem.

See original article @ The Guardian

Posted in adversity, anatomy of an epidemic, medication madness, sh!t is f#cked, what's going on?, what's up, doc? | Tagged | 1 Comment

fascination – Cabaret Voltaire


cabaret voltaireSlipping into new disguise,

Your eyes know, your body lies.
This fascination. This fascination. This, fascination.

 

 

 

 

 

Slipping into new disguise,
Your eyes know, your body lies.
This fascination. This fascination. This, fascination.

Your thoughts, closed off.
But it’s no concern, concern of yours.
Just fascination. Just fascination. Just private, fascination.

Hide away in secrecy,
You chop away this fantasy.
This private fascination. This private, fascination.

But if they knew, you’d shoot yourself.
A beast, you’d shoot yourself.
This private, fascination.
Just fascination. This fascination. This private fascination.

Glances back, slip in the way, swift.
You’ve found another way of,
Slipping into your disguise,
Your eyes know, your body lies.
This fascination. This fascination.
Just fascination. Just fascination. Just private, fascination.
This private, fascination.

Drive away in privacy,
You chop away this fantasy.
Your thoughts, closed off.
But it’s no concern, concern of yours.
Just fascination. Just fascination. Just fascination.
Just private, fascination. Just private, fascination.

A glance back, slipping away, the slip.
You pack another way.
But if they knew, you’d shoot yourself.
A beast, you’d shoot yourself.
This private fascination. This fascination. This fascination.
This private fascination.

This fascination. This fascination. This fascination.
This private, fascination. This private, fascination.

 

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the unreasonable man -George Bernard Shaw


George Bernard Shaw1

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“Mental health services” or compliance services?


non-compliantHow did mental health become so much about “compliance” and non-compliance?

What other branch of medicine even has the notion that a patient must comply ?

If people were offered choice - and I mean real choice,  not simply the false choice of “well, you either take the meds or we will force you to take the meds” – then compliance would not be an issue.

There would be no need for court involvement that brings to bear the full force of the institutions of the state upon an individual who is already in distress -and who, very likely has already suffered violence, abuse and bullying for much of their life.

There would be no need for the CTO that adds to a doctor’s prescription for medication the threat of police officers knocking at the door of the person who missed the bus and so was not at home when her assertive community treatment team worker called by to witness her take her pills.

And there would be no need for all compliance workers and there would be no need for all the paperwork involved.

There would be no need for every member of every family to be indoctrinated and brainwashed to believe that they have no role other than to become secret agents of  drug compliance forces and their should destroying surveillance, and scrutinizing and parroting over and over the one line they have been given in the performance that has taken over their life too: “have you taken your meds?”

We could spend less time talking about drugs and more time asking about the range of supports a person might find useful.

We could spend less money on services that ensure people comply with drug regimes and  more money on services that support healing, learning and growth and human rights.

oh Mr Diffendoofer, what a world this could be.

Do we have “mental health services”?
You tell me.

How much of what we call “mental health services” are more properly described as  “drug compliance services” ?

Related

Posted in bullying, Uncategorized, what's up, doc? | 3 Comments