The news from Washington this week (September 17 – See Scientific American) of another shooting where the shooter has been on psychotropic medication – this time trazodone – raises once again questions about the interaction between violence and medication.
The data points absolutely convincingly to the fact that the drugs can and do cause violence. Some of the data is laid out in an article Healy Herxheimer and Menkes published in PLoS Medicine on these issues seven years ago now.
Just because the data shows that certain drugs can cause violence, doesn’t mean that in a particular case where the perpetrator of a violent act was on medication that the drugs have in fact triggered this violence. In a majority of the cases I have been approached about, I have given the view that the drugs were not involved. It’s only when you accept the drugs can cause a problem that you can convincingly rule out their role in specific cases.
A report – Antidepressants and Homicide Redacted – prepared in a very unfortunate case I was involved in many years ago where the identifying details have been redacted gives some sense of the kind of profile a case should have and the chain of reasoning needed before a link can be proposed as possible or even likely in a specific case.
Over the past year, there have been a series of posts on davidhealy.org linked to cases and events hinging on prescription drugs and violence. See
The issues are complex and they evoke visceral reactions. I have attempted to take these into account in a series of lectures which give details of cases including photos of some of those involved.
The title of the post is deliberately Shooters on Prescription Drugs rather than Shooters on Medication. Both medicines and chemicals are chemicals – the difference between them lies in the fact that a medicine comes with information. The better the information the better the medicine. This sets up a contrast between medicines and drugs which include street drugs or drugs being used illegitimately. Unfortunately where the term medicine was once synonymous with a prescription drug – this is no longer the case. Because the data on their hazards are hidden and their benefits touted in ghostwritten articles, prescription drugs have moved a lot closer to street drugs in terms of the quality of information linked to their use.
Violence is the prescription drug linked problem for which this is most clearly the case. We know people taking street amphetamine or serotonin reuptake inhibiting drugs like cocaine get violent – we are told this is flat out not possible on prescription amphetamines or SSRIs.
Given the current lie of the land, an expert getting involved in making a case for drug induced difficulties has to stick to clearcut cases. This means that a lot of people with prescription drug induced problems are falling foul of the criminal justice system at a huge cost to society and themselves.