Talk:Antipsychotic/Archive 2

Misuse and abuse (looking for opinions)

I changed the term misuse to recreational use of the grounds that the terms were not neutral. This was reverted.

The arguments for misuse and abuse that I can understand are:

• This is the term used in some medical literature. This is accurate there are more results for drug misuse than recreational drug use (though the term does exist in literature).
• Some so-called misuse can extend to non-recreational uses of a drug. E.g. using benzodiazapines for anxiety while flying without a prescription
• This is the term used in the paper.

My arguments for "recreational use" or perhaps "recreational and off-label use" would be:

• The term abuse and misuse are clearly pejorative. In reusing them one is empowering the medical and psychiatric profession to push judgments into literature. No one who engaged in these activities would refer to themselves as "abusing" a drug apart form in jest.
• Though knowing the appropriate terminology for searching can be useful, this is part provided by the citations.
• Using the same terms can provide clarity when verifying references, quotations and footnotes can be used instead.
• These are not nouns but verbs, extending a definition into the verbs that you can use when taking about these terms have quite a strong effect.
• The reader may well not be aware that this is a definition because the terms are so common, so will perhaps read it as bias.

This is a rather problematic trade off. The term of art seems almost designed to be pejorative, far reaching, and to prevent disagreement (pieces of text get to repeat abuse again and again and again), and yet - it is the term of art that appears in literature. Is it wikipedia's job to use consensus terms that are thorougly biased? I think it is perhaps important because: psychiatry is contentious topic so it is important to appear unbiased so that the material is accepted by readers who may distrust the medical profession; an appearance to be "biased towards medicine" here could radicalize people - it is perhaps worth noting that many people will feel that psychiatrists are pill-pushers, and yet label other uses misuse.

I wonder if there is some precedent on the topic...

--Talpedia (talk) 00:08, 11 June 2020 (UTC)

• Ideally, you would find a source or two that meet WP:MEDRS and which criticize the usage of the terms, and then add that to the article. Abductive (reasoning) 02:48, 11 June 2020 (UTC)
• I doubt I would have any issue finding articles commenting on the terms drug abuse and drug misuse. I'm not sure I would be able to find one regarding the use of antipsychotics however. It would sort of feel off-topic to pull the general topic in. --Talpedia (talk) 08:38, 11 June 2020 (UTC)
• @Talpedia: This is a really interesting topic, and I am glad that you reached out here for more opinions. As I reverted your edit, I will explain my rationale here. While I agree that the terms of art can be misconstrued as pejorative, there are good medical reasons for the terms. The term "off-label" refers to the prescribing of a medication in a way inconsistent with regulatory body (e.g. FDA) labeling, and not the use of a medication by a lay person without a prescription. Prescription medications are considered "dangerous drugs" by their very nature, which is why they are available by prescription only. Using a dangerous drug in a way that it was not prescribed is therefore misuse, and the recreational use of a dangerous drug can result in harm, which is abuse (even if that harm is, for all intents and purposes, merely "legal harm" from using a prescription-only medication without a prescription). I perceive that this is why the medical literature uses the terms, and I am inclined to agree. Therefore, I believe that we should indeed use the terminology found within the reference material.―Biochemistry🙴❤ 21:16, 11 June 2020 (UTC)
• @Biochemisry: So I don't understand why the meaning of a word changes depending upon who decides you uses decision - but I guess this is mostly question of linguistic. Surely the use of a drug is intrinsically misuse or intrinsically abuse regardless of the process by which a decision was made, and the meaning should not change, say, which country you are in and the laws they happen to hold. A pupil does not e.g. abuse or misuse a band-saw by virtue of not getting permission to use it, but such actions are dangerous and have an approval process attached to them. I would have thought the words illegal, illicit, non-prescribed and unapproved capture these notions better than the word misuse and abuse that seem to deal with objective properties intrinsic to an action rather than the process by which a decision is made. What do you think of the following sentence: "After John lost his health insurance he started abusing drugs, taking medication for his thyroid condition at exactly the same dose as he was prescribed before without the approval of his doctor." --Talpedia (talk) 10:17, 12 June 2020 (UTC)
  • @Talpedia: I appreciate your point. However, the point that we use different words to describe the unsupervised use of dangerous tools (like band-saws) and dangerous drugs is not an argument against using the terms of the art particular to the respective fields of woodworking and medicine, in faith to the reference.

To answer your question, it should first be noted that the loss of health insurance has no bearing upon whether a particular medication is still prescribed by John's doctor, so the question itself is a little confusing. While I do not think that this kind of use (i.e. unsupervised continuation of previously prescribed pharmacotherapy for a medical purpose) is the kind that is referred to in the reference (i.e. unsupervised use of not prescribed medicines for a non-medical purpose), I would classify this kind of use as "misuse," as it can be dangerous to continue to use dangerous drugs without medical supervision. For example, a person's thyroid hormone requirement may decrease with age, requiring dose reductions to prevent overdose. Even in the case of antipsychotics, unsupervised continuation—without medical monitoring and interpretation of serum cholesterol, blood glucose, and other metabolic parameters, to say nothing of EPS monitoring—is not a safe practice.―Biochemistry🙴❤ 17:01, 13 June 2020 (UTC)

I agree recreational is a better and more neutral term. The terms misuse and abuse seem to imply it is against the law or regulated, but that may not always be the case depending on a person’s country/jurisdiction or other contextual factors. Pythagimedes (talk) 01:28, 14 June 2020 (UTC)

Drug abuse/misuse and recreational drug use have very different connotations. They are not mutually exclusive either. We can talk about all three of these things in the article. The author of the reference source may have conflated some of these ideas, but that doesn't mean this article should. Pythagimedes (talk) 06:53, 14 June 2020 (UTC)

@Pythagimedes: If we do not faithfully reflect the reference, we are conducting original research. Just as one can argue for the negative connotations of "misuse" and "abuse" (and I've explained the medical context of these terms above), one can argue for the positive connotation of "recreational", which conveys a false sense of innocuousness to the unsupervised use of dangerous drugs. It is not a neutral term.―Biochemistry🙴❤ 23:53, 17 June 2020 (UTC)

While I completely disagree with your perspective on this, I respect your arguments, and I’m not really that concerned about it either way. Pythagimedes (talk) 01:06, 18 June 2020 (UTC)

@Pythagimedes: Thank you for the candid and cordial discussion.☺ ―Biochemistry🙴❤ 19:36, 18 June 2020 (UTC)

Hello again y'all, I just happened to be reading WP:MEDMOS and I noticed something relevant to this discussion. It says "The term drug abuse is vague and carries negative connotations. In a medical context, it generally refers to recreational use that carries serious risk of physical harm or addiction. However, others use it to refer to any illegal drug use. The best accepted term for non-medical use is "recreational use". Pythagimedes (talk) 18:21, 29 June 2020 (UTC)

Potential for recreational seems to be mostly relevant for coinciding effects of some of these neuroblockers. In other words, and remarkedly unique to the class of blockers in general, antipsychotics dont have a real recreational use. Some antipsychotics just happen to overlap into different class of drugs or make themselves avaiable as a tool to destroy the self. You could call self harm a recreational past time, but i dont believe it is too accurate or fitting. Consider changing the sections title. DrBoller (talk) — Preceding undated comment added 11:42, 23 November 2021 (UTC) But as with any substance, some organisms react wildly anomalous to it. DrBoller (talk)

Content removed due to block evasion: Chemical Lobotomy

I guess it's important that blocks are blocks, so I'm not going to argue that removed material be readded. Nevertheless I don't entirely disagree with what they have to say, and as I am not blocked I'll express my opinion on the topic.

It's pretty plausible that the term "Chemical Lobotommy" was used when antipsychotics were first developed, given that lobotomies were happening at this time, and antipsychotics presented an alternative. While I don't think it would be WP:DUE for this to be present in any scientific discussion. I think it might be useful historically and that it might help frame some of the sociologically discussions about why antipsychotics are actually prescribed. The "chemical cosh" versus "chemical imbalance" argument is still alive and well. Talpedia (talk) 17:56, 27 December 2021 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 January 2019 and 26 April 2019. Further details are available on the course page. Student editor(s): Mojoad33. Peer reviewers: Fariba14, LaShaeDavis.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 14:29, 16 January 2022 (UTC)