Murphy’s Law

© Icefields | Dreamstime.com

© Icefields | Dreamstime.com

In December of 2013, Congressman Tim Murphy, a Republican representing the 18th District of Pennsylvania, introduced H.R. 3717, the Helping Families in Mental Health Crisis Act. You can red a shorter summary of it here. Almost immediately, it drew opposition from several advocacy groups. H.R. 3717 says it’s purporse is: “To make available needed psychiatric, psychological, and supportive services for individuals diagnosed with mental illness and families in mental health crisis, and for other purposes.” Why would advocates for the mentally ill be opposing a bill that is supposed to help the mentally ill?

One of these was MindFreedom, a nonprofit organization that seeks to nonviolently unite “people affected by the mental health system with movements for justice.” MindFreedom noted that the bill eliminated legal advocacy on behalf of those with psychiatric disabilities. It cut 85% of the existing funding for protection and advocacy programs. Under the bill individuals with psychiatric disabilities won’t get the same HIPPA protections. It would increase institutionalization, giving more money to psychiatric institutions than programs to help people live within the community.

A press release from the Mental Health Advocates suggested the measure would reverse some of the advances of the last 30 years in mental health services and supports. “It would exchange low-cost services that have good outcomes for higher-cost yet ineffective interventions.”  The bill was said to target the rights of individuals with mental illnesses and restructure federal funding “to heavily encourage the use of force and coercion.” It would seek to expand involuntary outpatient commitment (IOC), where an individual with serious mental illness would be court-mandated to follow a specific treatment plan, typically requiring medication.

Several bloggers for Mad in America also voiced their opposition to the legislation. Corinna West said the bill “replaces peer support, which works, with forced treatment, which doesn’t.” She cited the National Association of State Mental Health Program Directors, who after a review of forced treatment found it wasn’t helpful. Additionally, peer support was the #1 most effective method. She also noted in her December 2013 article that two of the top five industries donating to Rep. Murphy’s reelection campaign were healthcare professionals and the pharmaceutical industry. We’ll return to this issue later.

Faith Rhyne noted the legislation presented itself as having “worst case scenarios in mind;” that it was “not about most people” with psychiatric diagnoses. However, the criteria in the bill for patients eligible for IOC are not limited to individuals with a history of violence and incarceration. “It includes those with a record of non-medical hospitalizations,” and those deemed unable to care for their basic needs. “In many ways the legislation carries the theme and intent of E. Fuller Torrey’s Treatment Advocacy Center, which is noted on Representative Murphy’s website as being a leading supporter of the bill.”

Mad in America wrote an editorial opposing the bill, focusing on the dangers of the mandated treatment relying on antipsychotic medication. The editorial referred to research showing that these medications shrink the brain and may actually impair recovery. “But American psychiatry and the NIMH have never publicized those findings.” The false impression of the benefits of antipsychotics made passage of H.R. 3717 possible.

The House Subcommittee on Health held a hearing on H.R. 3717 on April 3, 2014. You can watch a video of the hearing and review documents associated with it here. Still trying to gain support for the bill, Rep. Murphy addressed the American Psychiatric Association in May of 2014. In his introduction, he was called “a friend of psychiatry.” He gave an impassioned plea of support for his “comprehensive mental health legislation.” The APA President, Paul Summergrad said:

The APA is committed to achieving needed legislation to transform mental health care on the basis on the best science and clinical care. We are pleased to work closely with Representative Murphy as well as Representative Barber and others to craft the best bill to benefit the American people.

Elise Viebeck reported for The Hill that House Republican leaders announced in June of 2014 they were going divide the Murphy Bill into pieces in an attempt to pass the less controversial provisions. This was said to be a major blow to the bill and Rep. Murphy, who had argued that only “dramatic and comprehensive reform” would help people with serious mental illness. “The defeat of the comprehensive bill is a victory for the broad swath of national mental health groups that were uneasy about or opposed to Murphy’s legislation.”

But Murphy continued to lobby for support of his comprehensive bill.  A December 2014 updated summary of H.R. 3717 listed 34 organizations supporting the bill, including the American Psychiatric Association and the American Psychological Association and the Treatment Advocacy Center. There were 115 cosponsors of H.R. 3717.  The twenty-one media outlets included: The Wall Street Journal, The Washington Post, the Pittsburgh Post-Gazette, the Seattle Times, and the Houston Chronicle.

In February 2015, Congressman Tim Murphy was a keynote speaker at an event, “Fixing America’s Mental Healthcare System.” He said he hoped to reintroduce H.R. 3717 as early as March of 2015. Senator Chris Murphy, who participated in the same panel discussion event as Congressman Murphy, voiced his intent to introduce similar legislation in the Senate this year. Senator Murphy is from Connecticut, where the Sandy Hook shooting took place.

Rob Wipond of Mad in America, citing a 2013 analysis of the bill by the National coalition for Mental Health recovery, once again noted how the existing legislation would “heavily encourage the use of force and coercion.” This would likely involve “treating people with pharmaceuticals. It would undermine the rights and legal support of people seeking non-drug options. It would cut funds for community-based services with a proven track record of helping people stay out of the hospital. “(T)his bill would cost more money for worse outcomes.”

Wipond also cited information on donors to Congressman Murphy for the 2014 election cycle. Maplight listed contributions from pharmaceutical companies such as: GlaxoSmithKline, AstraZenaca, Pfizer, Johnson & Johnson, Merck & Co, Eli Lilly & Co.—many of them on multiple occasions.  Murphy received $95,830 from 10/1/2012 to 9/30/2014 from pharmaceutical/health care product companies.

OpenSecrets.org reported that within Murphy’s top 20 contributions from industry were health professionals, pharmaceuticals/health products, hospitals/nursing homes, and health services/HMOs. Murphy received over $283,000 from the political action committees related to these industries for the 2014 election cycle. There were individual contributions in addition to these. His campaign committee reported that during the 2013-2014 fundraising cycle they raised $1,854,010. In his political career from 2001-2014, he has received $701,235 in contributions from health professional political action committees, and $430,030 in contributions from pharmaceuticals/health products political action committees.

In all the readings linked here; in the videos I watched of Congressman Murphy gathering support for his bill, I did not hear any substantive reference made to the concerns raised and noted above by MindFreedom, Mental Health Advocates, or Mad in America. Specifically, I did not hear anything addressing the concern for the proposed IOC.

Congressman Murphy advocates for increased social control over individuals with “mental illness.” He’s a friend of psychiatry, who dismissed the opponents to his legislation as marginal and “anti-psychiatry” in his rhetoric to the American Psychiatric Association. He is passionate in his views and has a well-polished stump speech that he gives as he drums up support for his legislation. He has been heavily supported by the medical and healthcare industry throughout his political career. And he is getting ready to try again to get Congress to approve legislation giving psychiatry increased power and authority.

This is happening just as the validity of what he has referred to as “anti-psychiatry” is becoming more widely known and accepted. What’s more, there is scientific evidence to support much of it. The evidence-based “treatment” of psychiatric medications has been repeatedly shown to be marginally effective at best. Look at the information on Mad in America; Psychiatric Drug Facts and PsychRights.

Any legislative reform that gives psychiatry more power should be sidelined until the existing questions on the validity of psychiatric diagnosis and practice are resolved. Otherwise, we may have to live with the consequences of a different Murphy’s law—anything that can go wrong, will go wrong. If we really want to help the “mentally ill,” we should wait until we are clear that the proposed changes will help and not harm them.


Hellish Withdrawal 101

© : Todd Arena 123RF.com

© : Todd Arena 123RF.com

Melissa Bond described herself as never having any physiological or psychological dependencies on anything “… besides perhaps rock climbing, yoga and writing large volumes of poetry.”  She developed pregnancy-related insomnia and went to an MD who specialized in hormonal imbalances, where she confirmed her insomnia involved an endocrine problem. She didn’t know at the time that her doctor had a “strong proclivity for prescribing benzodiaepines.”  You can read about her experience in the article she did for Mad In America: Killer Brain Candy.

After 2 years of Ativan for pregnancy-related insomnia, and the knowledge that the drug was slowly disassembling her brain and body, Melissa Bond went through a hellish withdrawal. She writes about it on her website and in her forthcoming book “Dear Little Fish.”

Melissa followed medical advice; and was told by a doctor who she trusted and respected that he knew a man who had used benzos for nineteen years and didn’t have a problem. “This drug, he told me, is phenomenal. You’ll sleep. And when you don’t need them anymore it may or may not be slightly difficult to get off but you’ll be fine.” That wasn’t what happened.

The advice I give to the drug addicts and alcoholics applies here as well. Whenever a medical person recommends that you take a potentially addictive drug for any reason, ALWAYS ALWAYS get a second opinion from someone with knowledge about addiction. Do research on people who have used the medication being prescribed to you. Mad in America, RxISK and Psychiatric Drug Facts with Dr. Peter Breggin are good places to start. And as you will see on these sites, hellish withdrawal problems aren’t confined to just the drugs classified as “addictive.”

What follows is just some basic information on how drugs are classified as controlled substances by the U.S. government. Remember that Melissa’s experiences were with a benzodiazepine, which are considered a Schedule IV controlled substance—the next to the lowest of the schedules.

There was a time when there was no federal laws regulating the use or distribution of drugs. Cocaine was in wine, cola and toothache drops; opiates were in everything from cough suppressants to teething medication. As a direct result of the Hague Convention in 1912, which was an international attempt to regulate opium, the U.S. passed the Harrison Tax Act in 1914. But it only regulated and taxed the production, importation and distribution of opiates and coca (cocaine) products. Doctors could prescribe these “narcotics” in the course of medical treatment. However they could not be used as a way to treat addiction.

While the Controlled Substances Act (CSA) of 1970 essentially replaced the Harrison Tax Act, there have been several lasting effects from this 100 year-old legislation. It began using the term ‘narcotics’ to refer to any illegally used substance. It also initiated the social construct of the “criminal” drug addict and the black market for drugs. But there still wasn’t any federal oversight and regulation of drug development. It wasn’t until the 1962 Kefauver-Harris Amendments that the Food and Drug Administration (FDA) was created, which was to approve the safety and effectiveness of a drug being developed for human consumption.

The CSA is the federal drug policy regulating the manufacture, importation, possession, use and distribution of certain substances. It created five Schedules or classifications for drugs; with varied qualifications for a substance to be included in each of the schedules. Two federal agencies, the Drug Enforcement Administration (DEA) and the FDA typically determine which substances are added to or removed from the various schedules. There have been several amendments to the CSA since 1970, including the Psychotropic Substances Act of 1978 and The Electronic Prescriptions for Controlled Substances Act of 2010.

The placement of a drug into a specific Schedule or the reclassification of a drug from one Schedule to another is based upon a series of laws under Title 21, which governs food and drugs in the United States. Each Schedule requires that the “potential for abuse” for a substance has to be determined before in can be placed within its respective Schedule. According to the DEA,  “The abuse rate is a determinate factor in the scheduling of the drug.”

The hierarchy begins with Schedule V drugs at the lowest level and ends with Schedule I drugs at the highest level. The designated abuse potential of drugs increases as you move up the hierarchy from Schedule V to Schedule I. Schedule I drugs are defined as having no current accepted medical use and a high potential for abuse. They are the most dangerous drugs, “with potentially severe psychological or physical dependence.”  Schedule V drugs are defined as having the lowest potential for abuse and are generally antidiarrheal, antitussive [cough suppressant] and analgesic medications. See the DEA link for a description of each of the five drug Schedules.

Sometimes the Schedule within which a drug is placed is controversial, and doesn’t seem to follow what would to be a common knowledge of a drug’s abuse potential. One example of this is marijuana. While it has a significantly lower dependency liability and harm potential than heroin (See “The Most Addictive and Harmful Drugs”), it is placed within Schedule I with heroin. This means that research into its potential medicinal use is highly regulated and difficult to do. There are other times where drugs are rescheduled, as was the case with Vicodin, when it became a Schedule II controlled substance instead of a Schedule III controlled substance in October of 2014 because it had become the most widely abused prescription opioid.

The following chart places some of the more common drugs within their current Schedules. You can review a pdf of all Controlled Substances in alphabetical order if there is one you don’t see here and want to check.



Schedule I

Heroin, marijuana, LSD, peyote, mescaline, ecstasy, MMDA, ibogaine, Quaalude, psilocybin,

Schedule II

Cocaine, morphine, methadone, methamphetamine, hydromorphone, oxycodone, hydrocodone, fentanyl, Adderall, Ritalin, Concerta, Vicodin, codeine, Demerol, Nembutal, PCP,

Schedule III

ketamine, anabolic steroids, testosterone, Suboxone (buprenorphine),

Schedule IV

Xanax, Klonopin, Valium, Ativan, Soma, Provigil, Serax, Serenel, Talwin, Tramadol/Ultram, Halcion, Ambien, Lunesta, Sonata,

Schedule V

Robbitussin AC, Lacosamide, Pyrovalerone, Lomotil