Outside of very specific circumstances during hospitalization, doctors can't actually force you to take any medication.
As soon as the doctors got their order for involuntary treatment in November 2015, they cornered my friend and injected her with a time-release version of haloperidol, then released her to her mother's house.
A day and a half later her mom called the psychiatrists, who said to take my friend to a real ER. My friend told the real doctors at the real ER that she was NOT suicidal. She told me how the haloperidol had 'hit her like a truck', and she tried everything she could think of to counteract the agony: alcohol, cocaine, heroin, dextromethorphan (aka cough syrup), etc.
All the anti-dopamine drugs are terrible. Some of the second-generation drugs that are forced on people are much worse than plain old haloperidol. The poor doctors are just implementing their training. Tragic.
My observation is that agony-inducing drugs are not actually helpful for substance abuse.
Sometimes these situations turn out tragically because the patient was involuntarily given drugs, sometimes they turn out tragically because the patient wasn't.
I'm surprised they went with a time release injection -- from the sounds of it, when you say "time release" you mean on the order of 30-90 days, not "12 hours". I'd have expected them to just work on stabilization and then moving to an outpatient program. I'm very surprised they'd have used it without any history of it being effective.
In a more recent tale with a family member undergoing an involuntary stay, I'd have wished they'd used a longer term haloperidol injection.
There's not a one size fits all solution, and it's hard to balance legislation around personal freedoms vs recognizing when the patient is a harm to themselves/others, or even capable of making informed rationale decisions.
> My observation is that agony-inducing drugs are not actually helpful for substance abuse.
Haloperidol isn't for substance abuse, so I wouldn't expect it to perform well at it.
When she got captured again, their thinking was "she's obviously back here because she didn't take her haloperidol". They never asked me about her alcohol consumption.
Whitaker's book points out that the Quakers' asylums fed people 4 meals a day and provided activities. iirc around 80% of the patients recovered to the point where they could leave the asylum. Think that was covered in Mad In America.
The psychotic patients who do the best, long term, are those who are never treated with antipsychotics. Those who do second best are those who are tapered off antipsychotics promptly. Those who do the worst are those who are maintained on antipsychotics in perpetuity.
To be charitable and more specific, If you are stable enough there's nothing technically stopping you from not taking prescribed medication and self medicating - as long as you remain stable enough to not warrant involuntary treatment. The obvious risk is if your prescribed medication (or a combination of prescribed and self prescribed medication) is making an impact, you could get worse.
From this comment it sounds like there's a lot you're leaving out of this story, but I'd like like be caucious of making generalising statements from specific personally related scenarios.
There's more than can be covered in a little comment.
I have the psychiatrists' September 2015 affidavits, filed in support of their petition for involuntary treatment. They say, essentially, "patient expects us to believe she was psychotic because she was drinking 2 bottles of liquor a day, and using cocaine. We know this is not the case because we previously got her 'stabilized' in 2008 and 2010 on haloperidol. She obviously does not appreciate that she is broken and requires anti-psychotics for the rest of her life."
My videos from August 2015 prove that she was actually fine before she ran out of alcohol, and that whatever deterioration the doctors think they're treating is entirely caused by palliative psychiatric drugs.
Haloperidol has one of the highest rates of side-effects[1], like permanent movement disorders, in its class, and it is neurotoxic[2]. Movement disorders like tardive dyskinesia don't seem like a good time.
Second generation antipsychotics typically have lower affinities for dopamine receptors compared to older drugs, thus lowering the severity of side-effects associated with dopamine blockade. They have much lower risks of causing movement disorders. They also bind to dopamine receptors differently than the strongly antagonist first generation antipsychotics. Some of them are partial agonists, inverse agonists, and full agonists with lower affinities at dopamine receptors, so they have less "anti-dopamine" activity than haloperidol and older antipsychotics do.
I agree with you that these drugs have terrible side-effects, but I'd argue that being loaded with haloperidol is one of the worse options to be treated with when it comes to bad side-effects. There's immediate release inectable versions of olanzapine, ziprasidone and clozapine, all second generation antipsychotics, but I suspect they cost more than haloperidol.
I think aripiprazole (Abilify) is the least-bad of the antipsychotics. None of them work when the psychosis is actually caused by malnutrition, cocaine, meth amphetamine, or alcohol.
Injection of these drugs is a form of violence.
From here[1]:
> What happens if the respondent isn’t compliant with the treatment order?
> It’s up to the judge but the idea is that non-compliance with a court order equates to contempt of court and is punishable by jail time. This is where the “teeth” or consequences are introduced for someone refusing to comply with the treatment plan. However, we have found that many counties do not enforce treatment orders with jail time.
When the option is to be compliant with treatment or be held in contempt of court, that sounds like force.