Prevalence of Psychotropic Medication Prescription among Federal Offenders

The prevalence of prescriptions of psychotropic medication was more common among federally-sentenced offenders than in the general Canadian population; however, it was commensurate with similar correctional jurisdictions

Psychotropic medications are those that can affect the mind, emotions, or behaviour. Such medications are quite commonly prescribed, but prescription rates are not currently available for Canadian federal offenders.

Given this fact, together with the relatively high rate of mental disorders among federal offenders, this study aimed to examine the frequency with which these medications are prescribed to offenders incarcerated in Correctional Service of Canada (CSC) institutions. Understanding the rate of prescription of psychotropic medications among this population is important not only for planning purposes but also to facilitate further research on this topic.

To examine this issue, CSC’s National Pharmacist, together with staff in the Health Services Sector, developed a list of all medications recognized as psychotropic. Regional pharmacists then provided a single-day snapshot of all active prescriptions for these medications on September 29. 2014. An in-custody population snapshot of all offenders provided the denominator in all prevalence calculations.

Overall, 30.4% of offenders had an active psychotropic medication prescription. Differences were seen by gender, with considerably more women than men having an active psychotropic medication prescription (45.7% and 29.6%, respectively). In contrast, there were no practical differences in the prevalence of prescriptions for Aboriginal and non-Aboriginal offenders. It was relatively common to have more than one active psychotropic medication prescription. Overall, 17.3% of offenders had an active prescription for one psychotropic medication, 8.2% had two, and 4.9% had three or more.

The most common psychotropic medication prescription category, according to the American Hospital Formulary System (AHFS), was antidepressant agents (including antidepressants, tricyclics and other norepinephrine-reuptake inhibitors, and monoamine oxidase inhibitors), for which 22.6% of offenders had an active prescription. Aboriginal offenders were slightly more likely than their non-Aboriginal counterparts (5.3% vs. 3.1%) to have prescriptions for central nervous system stimulants (including amphetamines, respiratory and central nervous system stimulants, and central nervous system agents).

The prevalence of prescriptions of psychotropic medication was more common in Canadian federal offenders than in the general Canadian population (30.4% vs. about 8.0%); however, it was commensurate with similar correctional jurisdictions (e.g., England, France, the province of Quebec). Additionally, the fact that women offenders were more frequently prescribed psychotropic medication than men offenders aligned with the higher prevalence of mental health issues in women offenders. However, the relationship between mental illness and prescription practices is a complex one, and more research will be required to understand it fully.

Farrell MacDonald, S., Keown, L.-A., Boudreau, H., Gobeil, R., & Wardrop, K. (2015). Prevalence of psychotropic medication prescription among federal offenders. (Research Report R-373).Ottawa, Ontario: Correctional Service of Canada.

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