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监狱环境中氯胺酮治疗的精神科和法律考量

Psychiatric and legal considerations for ketamine treatment within prison settings.

作者信息

Bayrhammer-Savel Michael, Ortner Martin, Van Hout Marie-Claire, Komorowski Arkadiusz

机构信息

Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.

Central Public Prosecutor's Office for Combating Economic Crimes and Corruption, Vienna, Austria.

出版信息

Front Psychiatry. 2024 Apr 18;15:1316108. doi: 10.3389/fpsyt.2024.1316108. eCollection 2024.

Abstract

The fundamental right to equivalence of health care in prison settings encompasses the provision of medication to address mental health conditions. Considering the increased risk for self-harm among individuals dealing with depression, the limited effectiveness of conservative antidepressants is a major challenge in psychiatry. The high prevalence of suicidal tendencies within prison populations underscores the imperative for state-of-the-art pharmacological treatment to uphold adequate health care standards. Notably, the denial of access to effective medication could be deemed a violation of human rights of people living in prison according to international treaties, domestic law, and United Nations normative standards of detention. This article presents the authors' perspective on the accessibility of ketamine treatment in prison settings, discussing psychiatric and legal considerations as well as current challenges in this context. Implementing novel psychopharmacological interventions may alleviate the distress experienced by individuals struggling with depressive symptoms and suicidality. At the same time, unprecedented treatment alternatives bring along potential issues, including limited understanding of long-term effects and the risk of abuse. Given the scarce data-availability, a pressing need exists for further research on the benefits and risks of ketamine treatment within prison populations.

摘要

监狱环境中医疗保健平等的基本权利包括提供治疗心理健康状况的药物。考虑到抑郁症患者自残风险增加,传统抗抑郁药效果有限是精神病学面临的一项重大挑战。监狱人口中自杀倾向的高发生率凸显了采用先进药物治疗以维持适当医疗保健标准的紧迫性。值得注意的是,根据国际条约、国内法以及联合国拘留规范标准,拒绝提供有效药物可被视为侵犯监狱服刑人员的人权。本文阐述了作者对于监狱环境中氯胺酮治疗可及性的观点,讨论了精神病学及法律方面的考量以及此背景下当前面临的挑战。实施新型精神药理学干预措施可能会减轻患有抑郁症状和自杀倾向者的痛苦。与此同时,前所未有的治疗选择也带来了潜在问题,包括对长期影响了解有限以及滥用风险。鉴于数据稀缺,迫切需要进一步研究监狱人口中氯胺酮治疗的益处和风险。

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Ketamine and esketamine in suicidal thoughts and behaviors: a systematic review.氯胺酮和艾司氯胺酮与自杀念头及行为:一项系统综述
Ther Adv Psychopharmacol. 2023 Feb 7;13:20451253231151327. doi: 10.1177/20451253231151327. eCollection 2023.

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