Chemical restraint

A chemical restraint is a form of medical restraint in which a drug is used to restrict the freedom or movement of a patient or in some cases to sedate a patient. These are used in emergency, acute, and psychiatric settings to control unruly patients who are interfering with their care or who are otherwise harmful to themselves or others in their vicinity. Chemical restraints are also referred to as a "Psychopharmacologic Agent", "Psychotropic Drug" or "Therapeutic Restraints" in certain legal writing.^[1][2]

Drugs that are often used as chemical restraints include benzodiazepines,^[3] antipsychotics, and Dissociative anesthetics.

In the United States, no drugs are presently approved by the U.S. Food and Drug Administration (FDA) for use as chemical restraints.^[4] According to the Nursing Home Reform Act, individuals have the right to be free from physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms.^[5] However, they are still used, and the FDA estimates 15,000 elderly individuals die each year by use of unnecessary anti-psychotics in nursing homes.^[6]

The use of chemical restraint has been criticized. It has been found to be mismanaged by health care workers for the convenience of the staff rather than the benefit of the patient, as workers use them to prevent patients from resisting care rather than improving the health of the patient.^[7] This has been found to cause more confusion in patients, thereby slowing their recovery.^[8]

References

1. "PHYSICAL RESTRAINT, MEDICATION AND SECLUSION OF PERSONS RECEIVING CARE, EDUCATION OR SUPERVISION IN A SCHOOL, INSTITUTION OR FACILITY". cga.ct.gov. Retrieved 2014-11-18.
2. OFDT (15 February 2011). "Juvenile Federal Performance-Based Detention Standards Handbook" (PDF). Retrieved 2014-11-18.
3. DiMaio, T.G.; DiMaio, V.J.M. (2005). Excited Delirium Syndrome: Cause of Death and Prevention. Taylor & Francis. p. 125. ISBN 9780203483473. Retrieved 2014-11-18.
4. Fleisher, G.R.; Ludwig, S.; Henretig, F.M. (2006). Textbook of Pediatric Emergency Medicine 355. Lippincott Williams & Wilkins. pp. 1–1812. ISBN 9780781750745. Retrieved 2014-11-18.
5. State of Connecticut (8 March 2007). "RESTRAINTS" (PDF). Retrieved 2014-11-18.
6. "ABC World News: Deadly 'Chemical Restraints' Kill California Nursing Home Patients - ABC News". abcnews.go.com. Retrieved 2014-11-18.
7. O'Donnell, J.; Ahuja, G.D. (2005). Drug Injury: Liability, Analysis, and Prevention. Lawyers & Judges Publishing Company. pp. 1–723. ISBN 9780913875278. Retrieved 2014-11-18.
8. Nay, R.; Garratt, S. (2004). Nursing Older People: Issues and Innovations. Churchill Livingstone. p. 246. ISBN 9780729537513. Retrieved 2014-11-18.