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Approved and Off-Label Use of Prescribed Psychotropic Medications among Federal Canadian Inmates
Gregory P Brown1, Lynn A Stewart2, Terry Rabinowitz3
11 Institute for Applied Social Research, School of Criminology & Criminal Justice, Nipissing University, North Bay, Ontario, Canada.
Summary
Off-label psychotropic medication prescribing in Canadian federal prisons is common, with 36.2% of prescriptions used this way. However, these rates are comparable to other correctional facilities and community settings.
Area of Science:
- Forensic Psychiatry
- Clinical Pharmacy
- Public Health
Background:
- Psychotropic medication is widely used in correctional facilities.
- Understanding prescription patterns, including off-label use, is crucial for patient safety and effective treatment within the Canadian federal prison system.
Purpose of the Study:
- To examine psychotropic medication prescription practices within federal Canadian penitentiaries.
- To determine the prevalence and patterns of approved versus off-label psychotropic drug use.
Main Methods:
- A purposive sample of 468 files from thirteen Canadian federal institutions was analyzed.
- Data included medication names, indications, dosage, frequency, and route of administration.
- Off-label use was determined by cross-referencing with Health Canada and pharmaceutical databases.
Main Results:
- 36.2% of psychotropic medication prescriptions were classified as off-label.
- Anxiolytics/hypnotics were most frequently prescribed off-label.
- No significant differences in off-label prescription rates were found based on Indigenous ancestry, gender, institutional infractions, or offense severity.
Conclusions:
- The rate of off-label psychotropic medication prescribing in Canadian federal prisons is not higher than in other correctional settings or community surveys.
- Prescription practices appear consistent across demographic and behavioral factors within this population.
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