Overprescription of Drugs

Order and Control

Prison reports and accounts from ex-prisoners, ex-governors, and prison doctors and other medical workers in Britain from the 1950s and 1960s provided some evidence of the use of psychotropic drugs to control “difficult” or “unruly” prisoners and those with various mental disorders, including schizophrenia and dementia. As the crisis of containment intensified and a small number of subversive prisoners were blamed for the increasing number of prison disturbances in the 1970s, so the allegations became stronger that drugs were being used for disciplinary purposes. Similarly, in the United States, there is evidence to suggest that psychotropic drugs were used in prisons and jails since at least the 1970s as a “quick, cheap, and effective” solution to warehousing increasing numbers of inmates into smaller spaces, while using fewer support services. “Healthy” inmates are frequently medicated without diagnosis or proper psychiatric and physical assessments. In Liles v. Ward (1976), a group of female inmates in a New York state prison were transported to a state mental hospital because they were deemed to be “disciplinary problems” by the correctional staff and placed on psychotropic medications (sometimes by force) in order to maintain peace and tranquility on the ward.

Gender

The overprescription of psychotropic drugs has to be understood in the context not only of wider concerns about prison (dis)order but also of the differential understandings of male and female criminality. Medical professionals and other criminal justice experts have traditionally sought to analyze, categorize, judge, and treat female offenders differently than men. The medicalization of female deviance, the drive to normalize women's behavior according to particular ideals of femininity, and the tendency of medical professionals to overprescribe mood-altering drugs for women are common practices. In the United States, significantly more women than men receive prescriptions for antidepressants, tranquilizers, and sedatives. They are also given them for different reasons. Within correctional facilities, the use of psychotropic medications on male inmates is often justified with reference to “problems of institutional control,” while female inmates tend to be drugged in the name of “treatment” in an attempt to correct their deviant behavior in a psycho-physiological manner.

There is some evidence to suggest that psychotropic drugs have been used disproportionately in terms of the rate of prescription per head of the female prison population. In their research study in Britain, Genders and Player (1987) found that large doses of antidepressants, sedatives, and tranquilizers were dispensed to women in prison, proportionately five times as many doses of this type of medication as men received in prison. A recent debate in Parliament also rekindled concerns that neuroleptics and other heavy tranquilizers are routinely prescribed to young women prisoners who mutilate themselves, and that medical drugs are used as pacifiers that move prisoners from nonaddictive illegal drugs to highly addictive medicinal drug use. In the U.S. context, Auerhahn and Dermody Leonard (2000) also found that it is the combined effect of being female and exhibiting behavior inconsistent with the normative requirements of the feminine ideal that often triggers the use of medication in their sample of inmates. Furthermore, they argued that the drugging of female prisoners and jail detainees can lead to disproportionately harsh outcomes for these offenders, including inability to participate fully in their own defense and to receive due process of the law.

...