Hospitals & Asylums   








State Mental Institution Library Education (SMILE)


Test Questions


To amend Chapter 4 Saint Elizabeth’s Hospital by replacing Subchapters I Establishment And Management; Pensions, Moneys, And Appropriations and; Subchapter II Inmates; Burden Of Expenses Thereof; Detention Of Insane; renumbering Subchapter III Mental Health System for the District of Columbia to Article X, transfer §321-329 from Chapter 9 Hospitalization of the Mentally Ill National Returned from Foreign Countries to Article 6 §189-194 of this Chapter, to recognize the new occupants of St. Elizabeth’s Hospital as U.S. Customs, to bring federal torture statute into compliance with the Convention against Torture (CAT), to abolish civil commitments and prohibit judge enforced medication, to terminate the license of all private psychiatric hospitals, state mental institutions and general hospital psychiatric wards, other than forensic, to transfer responsibility for Mental Health Courts to licensed social workers with adequate supervised community shelter bed support, to change the name of the Substance Abuse Mental Health Service Administration (SAMHSA) to the Social Work Administration (SWA), to take responsibility for the fact that antipsychotic and sleep aid drugs are the leading cause of lethal drug overdose reported to the National Poison Control Center and that withdrawal from antidepressant is peculiarly homicidal amongst hundreds of minor side-effects, to recall all prescription psychiatric drugs, to cure the dangerous autistic neuromuscular extra pyramidal and Tourette’s side-effects of antipsychotic and childhood stimulant medication with FDA approved antiviral flu drug Amantadine (Symmetrel), to recall that Zyprexa and alcohol has caused millions of deaths in diabetics and the United States needs a more responsible insulin manufacturer, to provide herbal alternatives for the treatment of anxiety and depression including St. John’s wort for mild cases and Valerian for more severe cases of nervous stress, lemon balm to soothe hyperactive children and chamomile to fall into a restful sleep, but some people are allergic, to avoid stimulants after noon, to implicate involuntary exposure to DOM (dimethoxymethylamphetamine) by narcs causing a three day panic attack and up to six months of mental illness if the patient is under stress or attempts to quit smoking cigarettes, to implicate E. coli and concentrated animal feeding operation (CAFO) pollution of the groundwater and food as the leading cause of senility and generalized anxiety disorder best treated with bottled water, metronidazole for infectious ulcerative diarrhea, iron and vitamin B12 supplementation for post-infectious diarrhea, and Stonebreaker herbal tincture for gluten intolerant gallstones causing upper right abdominal quadrant pain in athletes, to prescribe coffee and tea as the frontline hospitality for migraine and bronchitis respectively.


Be the Democratic and Republican (DR) two party system Abolished


1st Draft August 2004, 2nd May 2005 3rd 28 February 2007, 4th 30 July 2007, 5th 20&22 April 2009, 6th 16 March 2011, 7th 7 March 2013


1.This Act may be titled the State Mental Institution Library Education (SMILE) Act to express, in writing, the idea that a free public library education is the ideal treatment for otherwise unemployed people suffering from mental illness, the diagnosis of mental illness or discrimination on the basis of alleged mentally illness (ami).  Under 24USC(9)§326 (1&2) a psychiatric hospital must release a patient in 48 hours from making a request or begin judicial process in five days.  No patient held without criminal charge, who verbalizes their preference for community alternatives, whether or not they can afford them, should be denied release.  Timely torts regarding release create an enforceable Mental Institution Relative Release Order Request (MIRROR).  Should the MIRROR be broken, community re-investment of the hospital shall be locally enforced  by social worker pursuant to District of Columbia Mental Health System statute, as codified for St. Elizabeth’s Hospital under 24USC(4)III§225.  This Act establishes in the federal government a Social Work Administration (SWA) to supersede the Substance Abuse Mental Health Service Administration (SAMHSA).  This Act abolishes civil commitment, judge enforced medication and psychiatric emergency services (PES). This Act seeks to terminate the licenses of all inpatient psychiatric hospitals, private psychiatric hospitals, general hospital psychiatric wards and state mental institutions, other than forensic. This Act authorizes only licensed independent professional social workers to judge mental health courts, tort claims, and refer patients to residential treatment.  Medical professionals are reminded to treat the neuromuscular side-effects of antipsychotic and childhood stimulant medication with Amantadine (Symmetrel).  Antipsychotics and sleep aids are the leading cause of fatal drug overdose. Neuromuscular side-effects have manifested in all clinical trials of all antipsychotic drugs but Risperidone (Risperdal) that causes baldness.  Tricyclic antidepressants have also been found to be potentially fatally neurotoxic at regular doses and have been replaced with Supplemental Serotonin Reuptake Inhibitors (SSRIs) are known to cause more than 200 minor side-effects including a predictably peculiar homicidal tendency that is unscrupulously exploited.  Anxiety and depression are best treated with herbal teas such as St. John’s wort (Hypericum perforatum) and Valerian (Valeriana officinalis).  Lemon balm (Melissa officinalis) and milky oats (Avena sativa, A. fatua) are known to be an effective remedy for calming hyperactive children.  Chamomile (Chamaemelum nobile, Matricaria recutita and related species) will put you into a restful sleep, but some people are allergic. 


2. This Act (1) recalls all prescription psychiatric medicine (2) abolishes civil commitments to a psychiatric hospital  (3) terminates the licenses of all public and private psychiatric hospitals, including general hospital psychiatric wards, except forensic facilities for the criminally insane, (4) terminates Psychiatric Emergency Services (PES) (5) terminates the psychiatric residency and medical specialty, (6) terminates all funding for psychiatry and mental health, (7) finances licensed social workers to treat the mentally ill and (8) changes the name of the Substance Abuse Mental Health Services Administration (SAMHSA) to Social Work Administration (SWA).  (a) Reference to the Substance Abuse Mental Health Service Administration 42USC(6A)IIIA§290aa is amended to Social Work Administration, in the heading and at (a). (b) At 42USC(6A)IIIA§290aa-1(a)(1)(A) reference to Substance Abuse Mental Health Service Administration is amended to Social Work Administration.  As of 2014 the National Association of Social Workers (NASW) Code of Ethics has been wrongly hacked or amended.  The new ethical code is wreaking havoc on the confidentiality of the non-profit sector.  Diabetics are dying because licensed social workers, who might be educated on how to behave although the once true internet ethical code has been hacked, remain inaccessible to the non-profit sector free of psychiatric oversight and billing.  The Code no longer forbids social workers from testifying or b(k)illing a client, only deaths are confidential.  Eli Lilly & Co. similarly bought an injunction against millions of cases of Zyprexa and alcohol causing diabetes and wrongful death in diabetics.  A more responsible U.S. manufacturer of insulin could not be fined $5 million for this theft of trade secrets from the NASW Code of Ethics.  Who hacked the American Medical Association (AMA) Code of Medical Ethics around 2012?  Insulin dependent diabetics should be particularly alert for counterfeit lethal injections and might try to wean themselves off the needle with oral diabetes drugs.  50% of juvenile onset diabetics die within 20 years of diagnosis.  If licensed social workers are to inherit the Mental Health Court, they must surely prove the current version of the internet NASW Code of Ethics wrong.  No billing, no testifying, no dying, no psychiatry. Diabetic Famine: Metronidazole, Vibramycin, and the Unusual Treatment of Juvenile Onset Diabetes and Peripheral Diabetic Neuropathy HA-28-10-14 and Government Publishing Office v. Microsoft Corporation HA-28-1-15.


3. St. Elizabeth’s Hospital, was founded by Dorothea Dix in 1855 with a maximum capacity of 250.  However by the 1940s, the Hospital complex covered over 300 acres and housed 7,000 patients. It was the first and only federal mental facility with a national scope. Politicians were importing mentally ill people.  In 1987, the National Institute of Mental Health (NIMH) acting in behalf of the federal government transferred the hospital operations to the District of Columbia, while retaining ownership of the western campus. Under the regulation of the District of Columbia Council the patient population steadily declined, and the Hospital now houses only 600 patients in 1992.  In 2010 the Department of Homeland Security assumed control of the property, wherefore the sixth draft makes technical amendments, on the condition that Title 6 of USC and CFR be re-named “Customs”.   The World Health Organization Report on Mental Health of November of 2001 estimates that mental illness and psychological disorders stemming from substance abuse affect a combined total of 450 million people, 7.3%, of the 6,137,000,000 global population.  The Surgeon General’s Report on Mental Health of 1999 stated that 55% of Americans suffered from mental illness at some time in their life and 1 in 5 Americans experience a diagnosable mental disorder in any given year, more than 5% serious.  Suicide is the 3rd leading cause of death among 15 -24 year olds. In 1997 30,535 people died from suicide in the U.S.  It was the 11th leading cause of death in 2000 for all age groups.  The highest suicide rates are found in white men over the age of 85. 


Twelve-month prevalence and severity of DSM-IV disorders, 2003











I. Any Mental Disorder





One disorder





Two disorders





Three or more disorders





II. Any anxiety disorder





Panic disorder





Agoraphobia without panic





Specific phobia





Social phobia





Generalized anxiety disorder





Post-traumatic stress disorder





Obsessive-compulsive disorder





Separation anxiety disorder





III. Any mood disorder





Major depressive disorder










Bipolar I-II disorders





III. Any impulse‑control disorder





Oppositional-defiant disorder





Conduct disorder





Attention-deficit/hyperactivity disorder





Intermittent explosive disorder





IV. Any substance disorder





Alcohol abuse





Alcohol dependence





Drug abuse





Drug dependence






4. The most prevalent mental diseases are; a. “major depressive disorder” affecting 9.9 million people or 5% of the U.S. population every year; b “Bi-polar disorder” affecting 2.3 million U.S. adults or 1.2 % of the U.S. population; c. “Schizophrenia” affecting 2.2 million U.S. adults about 1.1% of the U.S. population; d. “Anxiety disorders” affecting 19.1 million U.S. adults; e. “panic disorder” is an anxiety disorder that affects 2.4 million U.S. adults, f. “Generalized Anxiety Disorder” is an anxiety disorder affecting 4.0 million or 2.8% of the populace, g. “Social Phobia” affecting 5.3 million or 2.8% of the populace.  h. “agoraphobia and specific phobia” affects 5 million people.  i. “Attention Deficit Hyperactivity Disorder” is a disorder that affects 4.6% of school age juveniles.  j. “Alzheimer’s disease” affects an estimated 4 million senior citizens.  k. According to US Army reports the suicide rate for American soldiers serving in Iraq is 17.3 per 100,000, nearly five time the rate for the Gulf War and 11% higher than for Vietnam.  Over 19% of OIF veterans and almost 12% of OEF veterans reported some mental health concerns (e.g., PTSD, depression, and anxiety).  Nearly 10% of OIF veterans and 5% of OEF veterans reported symptoms of PTSD.  Even when using a strict definition of anxiety, depression, and PTSD, they found that 8% of those surveyed reported anxiety, 8% reported depression, and 13% acknowledged PTSD-type symptoms.  The National Vietnam Veterans Survey (1990) found that 15% of veterans surveyed could be diagnosed with PTSD at the time of the survey, but that as many as 30% of veterans eventually developed PTSD at some point following their combat experience. During 1999 there were 1.7 million admissions to inpatient psychiatric treatment. 424,450 were involuntary commitments.  In 2000 at the Conference on the Report of the Surgeon General Ohio Director of Mental Health Mike Hogan PhD promised to, “close all state mental institutions and private psychiatric hospitals to provide unimpeded access to community mental health.”  On June 18, 2001 President Bush signed E.O. 13217 Community Based Alternatives for Individuals with Disabilities to (1) commit the United States to community based alternatives for individuals with disabilities (2) community programs foster independence (3) unjustified isolation or segregation through institutionalization is prohibited (4) states must take responsibility to place people with mental disabilities in community settings (5) states must ensure that all Americans have the right to live close to their families and friends, to live independently, to engage in productive employment and to participate in community life.  WHO recommends that in the future, “governments take responsibility for providing treatment for mental disorders within primary care; ensuring that psychotropic drugs are available; replacing large custodial mental hospitals with community care facilities backed by general hospital psychiatric beds and home care support.”  Dr. Hogan was appointed head of the New Freedom Commission on Mental Health in April 2002 by the President of the United States as a commitment to eliminate inequality for Americans with disabilities. 


5. Although the number of resident patients has gone down the overall number of admissions has increased.  In 1963, when the Community Mental Health Center Construction Act was passed, the median stay in a psychiatric hospital was 17 days and mean 20 days.  In 1975 the median stay was 6.7 days and the mean 11 days.  Since the 1950’s public funding policy has been to close state mental institutions in support of community based care.  The number of patient care episodes has both greatly increased and become increasingly directed to less than 24-hour treatment facilities.   In 1955 there were 1.7 million care episodes of which 77% were treated in 24-hour care facilities.  By 1971 there were 4.1 million cases of which 58% were treated in less than 24 hours, by 1998 11 million care episodes were treated only 24% of the time in 24-hour treatment centers.  The numbers show that de-institutionalization policies between 1970 and 1998 have been successful in reducing the supply of totally government funded psychiatric beds by a total of 376,704.  State and county mental institutions having reduced their number of inpatient beds from 413,066 in 1970 to 63,525 in 1998.  Likewise VA medical center psychiatric beds went down from 50,688 in 1970 to 13,301 in 1998. To compensate private psychiatric hospitals, non-federal general hospital and residential centers for emotionally disturbed children that are funded 68% by private clients’ HMO have increased 51,348 beds.  Between 1970 and 1998 Private psychiatric hospitals have increased in patient population from 14,295 to 33,635, Non-federal general hospital psychiatric wards have increased from 22,394 to 54,266, residential treatment centers for emotionally disturbed children increased from 15,129 to 33,483.  The total number inpatient beds of all “mental institutions” declined from 515,572 in 1970 to 198,195 in 1998.  The objective is to increase the number of residential beds and reduce the number inpatient beds.


6. Unlike other medical specialties the quality of care for Americans with mental health problems remains as poor today as it was several years ago.  This comes after decades of political improvement. Patients on antidepressant medication are about as likely to receive appropriate care today as they were in 1999.  Similarly, patients hospitalized for mental illness are only marginally likely to receive appropriate follow-up care according to the National Committee for Quality Assurance in 2006.  Even more alarming, Joseph Parks of the Missouri Department of Mental Health reports that people with serious mental illness die at age 51, on average, compared with 76 for Americans overall.  Their odds of dying from the following causes, compared with the general population.  3.4 times more likely to die of heart disease.  3.4 times more likely to die of diabetes.  3.8 times more likely to die of accidents.  5 times more likely to die of respiratory ailments.  6.6 times more likely to die of pneumonia or influenza. Adults with serious mental illness treated in public systems die about 25 years earlier than Americans overall, a gap that's widened since the early '90s when major mental disorders cut life spans by 10 to 15 years.  Psychiatric medication has become an accepted method for treating mental illness since the deinstitutionalization movement began in the 1950s.  Mental illnesses are among the most common conditions affecting health today: One in five American adults suffers a diagnosable mental illness in any six month period. According to the National Institute of Mental Health, though, some 90 percent of these people will improve or recover if they get treatment. Most will recover on their own without treatment, meditation is typically the best medicine. Adult use of antidepressants almost tripled between 1988-1994 and 1999-2000. Ten percent of women 18 and older and 4 percent of men now take antidepressants. The use of psychotropic drugs in children has risen 327% between 1985 and 1999. Prescription psychiatric medicine, neuroleptics; hypnotics (sleep aids) and antipsychotics have become the most frequent cause of fatal drug overdose reported to Poison Control Centers, and childhood stimulants and antidepressants the fifth.  A hypnotic is a drug that produces sleep, a sedative is one used to relieve tension and anxiety.  The most commonly used hypnotics and sedatives are the barbiturates but opiates ovderdoses have increased tenfold over the past 11 years. Anxiety and depression are best treated with herbal teas such as St. John’s wort (Hypericum perforatum) and Valerian (Valeriana officinalis).  Lemon balm (Melissa officinalis) and milky oats (Avena sativa, A. fatua) are known to be an effective remedy for calming hyperactive children.  Chamomile (Chamaemelum nobile, Matricaria recutita and related species) will put you into a restful sleep, but some people are allergic.  The Social Readjustment Ratings Scale, devised by the American doctors T.H. Holmes and R.H. Rahe, is a guide to assessing the potentially stress-inducing factors that may be affecting you at any particular point in your life.  The 41 positive and negative life events in the chart have each been assigned a value according to the amount of physical and/or mental adjustment required to cope with the event.  Those scoring more than 300 units in any one year may have a greatly increased risk of illness.  Bringing your score down to 150-299 reduces this risk by 30 per cent, while a score of 150 or fewer carries with it only a slight risk of illness.  Since individual responses to particular situations vary so greatly, you should regard your score as only a crude indicator of the way you are reacting to levels of stress. Many doctors today accept that 75 percent of illness is caused by stress related conditions.  Stress is not all negative.  It can be a very positive feature in our lives. 


Holmes-Rahe Stress Scale


Life event

Life change units

Death of a spouse




Marital separation




Death of a close family member


Personal injury or illness




Dismissal from Work


Martial reconciliation


Change in health of a family member




Sexual difficulties


Gain of new family member


Business readjustment


Change in financial state


Change in frequency of arguments with spouse


Major mortgage


Foreclosure of mortgage or loan


Change in responsibilities at work


Son or daughter leaving home


Trouble with in-laws


Outstanding personal achievement


Spouse begins or stops work


Begin or end school


Change in living conditions


Revision of personal habits


Trouble with boss


Change in working hours or conditions


Change in residence


Change in schools


Change in recreation


Change in church activities


Change in social activities


Minor mortgage or loan


Change in sleeping habits


Change in number of family reunions


Change in eating habits






Minor violation of the law


7. Antipsychotic medication and child stimulants such as Ritalin have all been found to cause neuromuscular tics, known as extra pyramidal side effects and Tourette’s syndrome, respectively.  In general, it is estimated that forty to fifty percent of medications are overused and mis-prescribed, especially tranquilizers (including barbiturate and opiate sleeping pills and mind-altering drugs particularly antipsychotic medication), cardiovascular drugs and gastrointestinal drugs.  The medications used to treat heart disease, high blood pressure and vascular disease are also widely abused.  Let it be known Hawthorne is the supreme herb for the heart.  First generation antipsychotics caused a 30 percent chance of permanently disabling tardive dyskinesia for every year of use.  With the exception of Risperdone (Rispderdal) that causes premature baldness in males, all second generation atypical antipsychotic drugs, including Lithium, are known to cause potentially life-threatening neuromuscular side-effects, known as extra-pyramidal symptoms, with just one regular dose, which is typically achieved gradually while under professional supervision in a psychiatric hospital.  Any prescription for antipsychotic medicine other than Risperidone (Risperdal) should be presumed to be medical malpractice and discontinued or changed to Risperdal (Risperidone) if concerned about a violent withdrawal. Extra-pyramidal side-effects of antipsychotic drugs can manifest after taking so little as one dose and may last until treated.  The symptoms present as neuromuscular tics that seize the face, arms are generally clenched, there is extreme anxiety to walk around which inhibits socialization.  The FDA approved, but untried, remedy, is the Parkinson’s antiviral drug Amantadine (Symmetrel), to replace Cogentin (benztropine mesylate) which cured extrapyramidal side-effects in minutes, in just one dose, but was withdrawn from the market in time to explain the recent increase in autistic tics, since second generation atypical antipsychotic medicine seized the market.  One half or one quarter dose, of either of these Parkinson’s drugs, is worth a try to permanently cure autistic tics in children and infants.  If Amantadine doesn’t cure autistic disorders don’t settle for less than Cogentin.  Amantadine (Symmetrel) must be made available to all people prescribed antipsychotic and childhood stimulant drug prescriptions to eliminate the risk of neuromuscular side-effects and should sponsor a drug trial to see if a half dose for children and quarter dose for infants will permanently cure autistic tics.  Just think: how many autistic children a school nurse might heal with one package of Amantadine (Symmetrel) and how many more with state sponsored manufacturing of Cogentin (Benztropine mesylate)? 


8. Benzodiazepines are named for their chemical structure, benzodiazepines are frequently used for the acute symptoms of anxiety because they are very effective and work within an hour but they are addicting.  They can be used intermittently, an attribute that some people find attractable.  Immediate side effects include sedation, poor physical coordination, and memory impairment. Daily use for months can dull your emotions, impair cognitive skills and contribute to depression.  Even if benzos help you initially, learn and use alternative methods of managing anxiety so you can get off of them when you are not stressed.  Selective Serotonin Reuptake Inhibitors (SSRIs) are named for their action in the brain and initially marketed for depression, SSRIs have proved to enormously helpful for people with different syndromes of anxiety.  They need to be taken every day and generally take some weeks to become effective, so they are not useful for acute anxiety.  Their day to day side effects are minimal in most people, although some people experience fatigue and a few become agitated.  Most people notice decreased sexual drive and impaired sexual response.  Tricyclic Antidepressants (TCAs) are named for their chemical structure.  TCA are effective for some forms of anxiety. They need to be taken every day and generally take some weeks to become effective, so they are not useful for acute anxiety.  They have been supplanted by other drugs, notably the SSRIs, because of their tendency to cause weight gain, dry mouth, constipation, sweating and light-headedness due to low blood pressure.  Tricyclic antidepressants have a desired therapeutic activity at low does, but produce life-threatening anticholinergic effects at high doses. Monoamine Oxidase Inhibitors (MAOIs) are named for their action in the brain.  MAOIs are very effective.  They must be taken every day, and they take weeks to become effective. Common side effects include weight gain, dry mouth, insomnia, impaired sexual response, and light-headedness due to low blood pressure.  Their most troubling side-effect is the potential to cause a stroke if you ingest adrenaline or adrenaline-like substances.  MAOIs can be used only with a fairly strict diet that avoids food or medicines that contain adrenaline or adrenaline-like substances.  These include cough and cold medicines and a variety of food products such as aged cheese and processed meats.  MAOIs need to be used with extra caution.  Low doses are often not effective for depression, however.  Buspirone is also sometimes used in chronic anxiety but has not been found to be effective.  When the manufacturer Eli Lilly claimed Prozacwas mostly free of side effects, the FDA immediately objected.  Such claims were inconsistent with the product labeling that states 15% of the patients in clinical trials discontinued due to adverse experiences.  The FDA demanded that Lilly stop making such unfair claims.  In fact, the label disclosure statement shows that Prozac has been linked to an astounding 242 different side effects, including 34 different medical problems in the genital and urinary tract alone.  Over a ten-year period Prozac was associated with more hospitalizations, death or other serious adverse reactions reported to the FDA than any other drug in America.  Two similar drugs for depression, Paxil and Zoloft, are of similar toxicity. 20 Unusually toxic drugs are drugs that are linked to more than 50 different side effects. To meet the unusually toxic test, these many adverse effects must also occur so frequently that at least 10 percent of the patients discontinued the drug during testing.  Prozac, Zoloft, and Paxil.  Have been known to cause more than two hundred different adverse effects.  Eli Lilly prevailed upon the U.S. District Court for an injunction against millions of reports of its blockbuster drug Zyprexa causing widespread diabetes in consumers, with millions of fatalities particularly when mixed with alcohol.  Marketing of the Zyprexa beginning in the 1990s coincides with a doubling of the national incidence of diabetes.


9. 5 HTP is a highly recommended and sold over the counter treatment for depression. 5HTP is a serotonin precursor and can help the body to make more serotonin and leave the available serotonin in synapses for a longer period of time, therefore directly affecting mood and warding off depressive symptoms.  5 HTP can also help with insomnia, agitation, fatigue and lack of motivation.  It is often helpful in chronic pain situations because it increases sleep needed for healing, improves mood and decreases sensation of pain.  Again 5 HTP should not be used with other antidepressant medications, especially selective serotonin reuptake inhibitors, or SSRIs. 5- HTP 100 mg two times daily.  SAMe can be helpful in the treatment of depression.  It acts as methyl donor and can help the body to complete and maximize its nerve connections in the brain.  SAMe has antioxidant activity therefore will help to reduce free radical damage in the body.  SAMe can help the body’s methyl metabolism improve, therefore functioning to increase energy, improve cognitive function and decrease pain.  SAMe has also been used to treat osteoarthritis, response tends to be noticed within the first month of use.  Insomnia, anxiety or mania states can be associated with overuse of SAMe.  Do not use SAMe with other antidepressant medications, especially selective serotonin reuptake inhibitors (SSRIs).  It may cause life-threatening symptoms (including agitation, tremors, anxiety, rapid heartbeats, difficulty breathing, diarrhea, shivering, muscle stiffness and excessive sweating).  SAMe dosage 400 mg daily.  St. John’s wort (Hypericum perforatum) can be very effective for treating mild depression, anxiety, stress, tension, nerve damage, and seasonal affective disorder (SAD).  To be effective against stress and depression, St. John’s wort needs to be taken over a 2 to 3 week period, and it is often cycled over several months to treat chronic depression and stress.  Hypericin, one of the herb’s active constituents, increases the metabolism of serotonin and melatonin, which aid the body’s ability to receive and store light.  Hyperforin, another important constituent, contributes to emotional stability by slowing the uptake of those “feel-good” neurotransmitters such as dopamine, serotonin and noradrenaline, allowing them to circulate longer in the body. Valerian rootValeriana officinalis is one the safest and most powerful herbal nervines, used for all manner of stress, insomnia and anxiety.  Valerian is a remedy primarily for stress, tension, insomnia and nervous system disorders. Studies show that it works by depressing activity in the central nervous system and relaxing the smooth muscles of the uterus, colon and bronchial passages.  Two compounds, valerenic acid and valerenal, have been found to induce sleep and indirectly raise levels of gamma-aminobutyric acid, a neurotransmitter that decreases central nervous-system activity and acts as a muscle relaxant. Valerian is effective both as a long-term nerve tonic and as a remedy for acute nerve problems such as headaches and pain.  For those people for whom valerian works, it works well.  Some people find it irritating and stimulating, rather than relaxing.  The root is rich in isovalerenic and valerenic acids, which give it powerful nervine properties.  Because of the volatile nature of its aromatic oils, valerian root is generally infused rather than decocted.  Generally considered safe.  If you take too much valerian you’ll begin to have rubbery-like feeling in your muscles, like they are too relaxed, or a feeling of heaviness.  Cut back the dosage so that you feel relaxed but alert.  Avoid taking large doses of valerian for an extended period of time, instead, use modest doses for just 2 to 3 weeks, with a week’s break before you begin taking the doses again.

10. Sleep aids are ranked with antipsychotic drugs as the leading cause of fatal drug overdose.  A survey by the National Institutes of Health conducted in the 1970s revealed that 17 percent of the total population was bothered greatly by insomnia, and among older people the percentage was even higher, with one out over four people over the age of 60 reporting serious sleep difficulties. About 10 billion sedative doses are manufactured each year in the United States.  Each year, at least 10 million Americans consult physicians about their sleep, and about half of them receive prescriptions for sleeping pills.  Barbiturates are all synthetic compounds derived from barbituric acid, which is a combination of urea and malonic acid.  Barbiturates, commonly known as sleeping pills, produce all degrees of depression, ranging from mild sedation to coma.  They depress brain function, and in large doses the rhythm of respiration.  The fatality rate is higher for barbiturates than any other type of addiction (more than 3000 barbiturate suicides per year, or 20% of all suicides in the United States, and more than 1500 deaths from accidental poisonings).  Alcohol potentiates the barbiturates, the two depressant are synergistic and the practice of using both undoubtedly accounts for the unusually high number of accidental self-poisonings and death from respiratory depression. Chamomile Chamaemelum nobile, Matricaria recutita and related species are useful for going into a deep, restful sleep.  Chamomile is a popular remedy for calming colic and childhood digestive issues.  Some people are allergic to chamomile. Opioid drugs, which include OxyContin, Vicodin and methadone, overdose deaths have increased for the past 11 years.  Only 17 percent of these deaths were suicides, meaning the vast majority were unintentional overdoses. The Department of Justice reported that fatal overdoses from methadone increased from 500 in 1999 to more than 5,000 in 2006.  Narcotics, also known as opioids, are derived from opium (Papaverum somniferum) that has been used for pain relief for thousands of years.  Opioids are the frontline against severe pain whereas other non-addictive painkillers are under development.  Percocet is usually prescribed for the first few days, then Oxycontin for more prolonged pain.  These drugs work on the central nervous system, as muscle relaxants do. They are addictive, but mild and graduated dosing and withdrawal help reduce or prevent the cravings and withdrawal symptoms.  Most patients fear becoming addicted but unless they have a history of addiction, this is a worry that is not likely to come true.  When chronic, severe pain goes untreated or is inadequately treated, problems can also arise, and those problems can become permanent.  Continuing, urgent pain signals from nerves can result in hypersensitivity in the injured area.  Potent opioids commonly use in the postoperative patient are morphine, Dilaudid, and rarely, Demerol.  In some cases, a superpotent synthetic narcotic, fentanyl, is used postoperatively.  Fentanyl is about 100 times more potent than morphine in relieving pain.  Weak opioids drugs, like Darvocet and Vicodin, are widely prescribed narcotics for mild to moderate pain following surgery.  Codeine is another weak opioid available in liquid form and more commonly used for mild to moderate pain in the pediatric population. Narcotic Antagonists prevent or abolish excessive respiratory depression caused by the administration of morphine or related compounds. Naltrexone became clinically available in 1985 as a new narcotic antagonist. Its actions resemble those of naloxone (Narcan), but naltrexone is well absorbed orally and is long acting, necessitating only a dose of 50 to 100 mg.  The State must ensure that Narcotic Antagonists are provided as rescue medicine with all opioid prescriptions. The disclosure of patient residential address by the pharmacy to the breaking and entering of the state office of the Drug Enforcement Administration (DEA) is probably the greatest aspect of opioid overdose risk, that can be reduced by state law abolishing the DEA reporting requirement of patient address under the Health Insurance Protection and Portability Act Pub.L. 104–191, 110 Stat. 1936, enacted August 21, 1996; and possibly eliminated by transferring the agency to the state Department of Health and prepared Drug Evaluation Agency (DEA) in the Food and Drug Administration (FDA) federally. 


Sanders, Tony J.  Chapter 4: State Mental Institution Library Education (SMILE). 8th Draft. 126 pgs. Hospitals& Asylums. 7 April 2015.

Test Questions