Monday, January 7, 2013

Are Guns to Blame, or Are Pills?

After Adam Lanza massacred women and children in Newtown, there have been more and more impassioned calls for greater gun control.

It does not seem to matter that the places with the strictest gun control laws have the highest gun crime rates. Nor does it seem to matter that, with nearly 300,000,000 guns in private hands, banning guns seems unrealistic.

Still, America seems more and more to be thinking that guns are the problem and that they need to be better controlled.

You don’t have to be a Freudian to note that blaming guns feels like blaming men. Could it be that Americans have been induced to hate guns because they appear to be phallic?

Stranger things have happened.

We pay lip service to the fact that many of those who open fire in schools or theatres seem to be suffering from psychiatric ailments. I and others have often pointed out that the lawyers and judges and legislators who emptied out the psychiatric hospitals a few decades ago bear some considerable responsibility for the fact that dangerous psychotics are running free on America’s streets and in America’s subway systems.

Yesterday, Daniel Kupelian made an intriguing point: many of these young serial killers had, in fact, been taking psychiatric medication. As is known by psychiatrists, these medications can in some circumstances provoke manic episodes, suicidal behavior and even homicidal behavior.

Kupelian has documented the psychiatric history of those mass murderers we know about, from Eric Harris to Andrea Yates. It’s a long list.

For all we know about the weapons that Adam Lanza and James Holmes and Jared Loughner used, we know very little about the psychiatric medications they were taking.

What conclusions should we draw?

First, we certainly do not want to say that these medications should be prohibited because some of them have some horrible side effects? Many of them have helped many patients.

Second, we do not know whether these people were given the proper medications in the proper dosages. We do not know whether they were prescribed by a psychiatrist or a general practitioner. We do not, in other words, know whether the psychotic killers were properly diagnosed and properly treated.

Of course, we believe in doctor/patient confidentiality, but we also know that if a psychiatrist’s records show a misdiagnosis or a poor choice of treatment, the psychiatrist might be held liable.

Third, I have no way of knowing how much or how little these medications contributed to the crimes that these people committed, that is, whether they were made crazy by their pills or whether their pills were ineffective in treating their psychoses.

Fourth, if certain classes of patients present higher risks of violence or suicide while on certain kinds of medications, then their treatment needs to be more closely monitored, perhaps from within the confines of a psychiatric institution.


Gyula Huszar said...

I've recently been chastised by a prominent neuropsychiatrist for proposing the same questions you have. These incidents are consolidating mental health professionals like no other. 'Reasoned Sense' has no place in the closed world of the prescriptive psychoactive drug industry, according to them. They have their reasons, and we, the great unwashed, are viewed as the armchair quarterbacks of the business of psychiatry and prescription. I can both sympathize with them and bristle at my exclusion from the discussions that, hopefully, are going on behind closed doors.

Anonymous said...

"Nor does it seem to matter that, with nearly 300,000,000 guns in private hands, banning guns seems unrealistic."

People who advocate gun control are not suggesting "banning" all guns or stopping all gun ownership. They are for gun CONTROL. What kinds, how to sell them, how long it should take, etc.

Because so many people own guns does not mean there cannot be effective gun control and regulation.

Second: you keep going on about how "psychotics" were let out on the streets a few years back. While there may possibly have been some random violence as a result, this has nothing to do with "school shooters" like Adam Lanza. These kids are almost always from "stable" middle class homes. It's another question entirely, different circumstances, different social backgrounds, different reasons. Stop muddling the issue.

Stuart Schneiderman said...

Where did you ever get the idea that psychosis could not afflict someone who comes from a stable, middle class home. Since schizophrenia is a brain disease, not a developmental affliction, your reasoning is lame, to say the least.

Actually, there has been more than a little random violence as a result of emptying out the mental hospitals... to say nothing of the homelessness.

No rational person contests the point. Some differ over whether or not it was worth it or whether it is realistic to start making it easier to treat people against their will.

Even if we are talking about gun CONTROL, as you say, how are you going to institute controls when there are so many guns.

In fact, the gun control laws did prevent Adam Lanza from purchasing a gun. He just stole them from his mother.

Besides, the places with the strictest gun control laws, places like Chicago and New York are not murder-free zones.

Anonymous said...

Well if there are "so many guns" now, after you institute much stricter gun control there will eventually be less guns, correct?

Your reasoning is like saying "But everybody drinks and drives! How could we ever stop it!" Before the days of DUI laws.

You're the one who is always going on about "executive" experience. Are you just throwing up your hands in total impotence at this particular challenge? Oh oh oh, there's so may guns out there! We can't do anything!

It's not like it's a biological virus or cancer growing out of control.

I never said psychotics couldn't come from stable middle class homes, or that SOME mass shooters may in fact be psychotic.

What I object to is the implication you constantly make that somehow mass shooters and "letting psychotics out of institutions" a few years back are somehow connected. They are not. Mass shooters may sometimes be psychotic, but this particular phenomenon is not correlated to the insitutionalization of crazies, or not. Not one prominent mass shooter I can think of anyway was one of those people "let out" onto the street. They generally explode from within "normal" homes.

Of course released psychotics may commit violence. But what does that have to do with things like Columbine or Lanza? Not much.

Gun control laws, or lack thereof, PUT the guns in Lanza's hands. If his idiot mother had not been able to buy semi-automatic rifles, he would not have had access to them. If better background laws had figured out she had an unstable son, she could not have had them in the house. If she had been legally required to keep the guns under lock and key around an unstable person, he couldn't have gotten them. Lax gun laws are precisely what made it easy for him to get access to guns, not the other way around.

No one said there would be "no" murder with stricter gun control.