LOS ANGELES - Marylandian -- Federal health authorities are sounding the alarm over the chronic use of antipsychotic and psychotropic drugs in America's nursing homes. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has prioritized enforcement actions to reduce psychotropic prescribing—especially among seniors with dementia. With over 15,000 facilities nationwide housing more than 1.2 million elderly residents, mental health watchdog Citizens Commission on Human Rights International (CCHR) warns the unchecked drugging of seniors constitutes systemic elder abuse.[1]

CCHR is urging lawmakers to adopt the recommendations of a United Nations human rights expert, Claudia Mahler, who called for prohibiting chemical restraints—drugs used to control behavior—in aged-care settings. Mahler's report criticized the drugging of seniors in care facilities, asserting that older persons are "more likely to be deprived of liberty in care facilities than in prisons." She further warned that antipsychotic use in dementia can double the risk of death.[2]

Although the National Partnership to Improve Dementia Care in Nursing Homes reported a reduction in antipsychotic use among long-stay residents—from 30.1% in 2011 to 14.5% by the end of 2021—those figures obscure concerning patterns of diagnosis manipulation. For instance, some nursing homes labeled seniors with schizophrenia, a diagnosis virtually unheard of in the elderly, to continue prescribing antipsychotics despite federal restrictions.[3]

Federal Warnings Ignored, Harm Continues

Warnings about the dangers of these drugs have spanned decades. In 2007, FDA safety official Dr. David Graham estimated at least 15,000 nursing home residents die each year due to antipsychotic use.[4] Dr. Peter Gøtzsche, a Danish physician and internationally recognized expert on pharmaceutical safety, places the toll from psychiatric drugs—including neuroleptics, benzodiazepines, and antidepressants—at approximately 209,000 deaths annually among Americans 65 and older. Sleep medications may contribute to an additional 320,000 to 507,000 deaths per year. Even short-term use has serious consequences. Studies show that for every 100 dementia patients prescribed newer antipsychotics over just ten weeks, one will die. Combining a benzodiazepine with a neuroleptic can increase mortality risk by as much as 65%.[5]

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Despite federal regulations dating back to 1987 that prohibit psychotropic use for staff convenience or discipline, enforcement has been lax. In 2005, the Food and Drug Administration (FDA) issued a black-box warning linking antipsychotics to death in dementia patients prompting some prescribers to sidestep restrictions by re-diagnosing patients.[6] Between 2015 and 2019, schizophrenia diagnoses among nursing home residents rose 194%—an implausible increase, attributed to efforts to preserve prescribing authority.[7]

In 2021, a New York Times investigation revealed that 21% of residents were still being given antipsychotics, often based on unsupported or false diagnoses. In 2023, the Centers for Medicare and Medicaid Services launched new measures to identify facilities inflating diagnostic codes to justify drug use—but the problem persists.[8]

Direct-to-Consumer (DTC) pharmaceutical advertising has also fueled drug overuse among seniors. A 2021 study found that television ads heavily influenced seniors' prescription decisions, especially in areas with high Medicare enrollment. Between 2006 and 2017, $528 million was spent promoting one antipsychotic.[9] In June 2025, the End Prescription Drug Ads Now Act was introduced to ban DTCA.

Psychotropic drug use in long-term care facilities is a human rights crisis. Studies show that roughly 16% of nursing home residents experience abuse, yet only 1 in 24 cases is reported. Disturbingly, up to 40% of staff admit to having psychologically abused residents.[10]

Reforms Urgently Needed

The ongoing harm inflicted on elderly residents is not an isolated lapse but a failure of oversight, ethics, and accountability, tantamount to elder abuse. CCHR urges U.S. legislators and regulators to implement such reforms as:

• Prohibit the use of antipsychotics and other psychotropics for behavioral control in seniors.
• Enforce civil, financial, and criminal penalties for physicians and facility administrators who violate this prohibition.
• Prohibit doctors from accepting gifts, payments, or perks from pharmaceutical companies while treating patients.
• End DTC advertising
• End pharmaceutical industry funding of the FDA to restore independent oversight.
• Abolish the Diagnostic and Statistical Manual of Mental Disorders as the central authority for mental health diagnoses, due to its authors' longstanding ties to drug manufacturers.

"What's happening in nursing homes today is not care—it's chemical control and a national disgrace," said Jan Eastgate, President of CCHR International. "Our seniors are not being treated—they're being sedated for convenience, often at the cost of their lives."

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CCHR, established in 1969 by the Church of Scientology and professor of psychiatry Dr. Thomas Szasz, urges Congress and state legislatures to outlaw chemical restraints in aged care and demand accountability from prescribers and nursing homes. "The nation's elderly deserve compassion and safety, not sedation, and dignity not death by prescription," Eastgate said.

Sources:

[1] Poliakoff & Associates, P.A., "Nursing Home Oversight and Antipsychotic Drug Use," 12 June 2025, gpoliakoff.com/nursing-home-oversight-and-antipsychotic-drug-use/

[2] Bridget Sleap, "'Chemical Restraints' Deprive Older People of Liberty," Human Rights Watch, 19 Sept. 2022, www.hrw.org/news/2022/09/19/chemical-restraints-deprive-older-people-liberty

[3] Carl Dimitri, "Brown Study Challenges Common Perceptions of Antipsychotic Use in Nursing Homes," Brown University School of Public Health, 5 Sept. 2024, sph.brown.edu/news/2024-09-05/nursing-homes-antipsychotics

[4] Testimony by Dr. David Graham, House Hearing, 110th Congress – The Adequacy of FDA to Assure the Safety of the Nation's Drug Supply General, 13 Feb. 2007, www.govinfo.gov/content/pkg/CHRG-110hhrg35502/pdf/CHRG-110hhrg35502.pdf, p. 66

[5] Peter C. Gøtzsche, "Prescription Drugs Are the Leading Cause of Death," Brownstone Institute, 16 Apr. 2024, brownstone.org/articles/prescription-drugs-are-the-leading-cause-of-death/

[6] Katie Thomas, Robert Gebeloff and Jessica Silver-Greenberg "Phony Diagnoses Hide High Rates of Drugging at Nursing Homes," The New York Times, 16 Sept. 2021, www.nytimes.com/2021/09/11/health/nursing-homes-schizophrenia-antipsychotics.html

[7] "Long-Term Trends of Psychotropic Drug Use in Nursing Homes," Health and Human Services Office of the Inspector General, 11 Nov. 2022, oig.hhs.gov/reports/all/2022/long-term-trends-of-psychotropic-drug-use-in-nursing-homes/

[8] Katie Thomas, Robert Gebeloff and Jessica Silver-Greenberg "Phony Diagnoses Hide High Rates of Drugging at Nursing Homes," The New York Times, 16 Sept. 2021, www.nytimes.com/2021/09/11/health/nursing-homes-schizophrenia-antipsychotics.html

[9] Robin Feldman, "Physicians Treating Alzheimer's Disease Patients Should Be Aware that Televised Direct-to-Consumer Advertising Links More Strongly to Drug Utilization in Older Patients," Jour. Alzheimers Dis. June 2021, pmc.ncbi.nlm.nih.gov/articles/PMC8293633/

[10] Usama Khan, "Elder Abuse Statistics," Retirement Living Journal of Retirement Research, 19 May 2025, www.retirementliving.com/nursing-care-facilities/elder-abuse-statistics