In all those years I labored in emergency departments, there was a common dread amongst nurses, ambulance personnel and first responders, yes, even physicians that a full moon brought out the latent instability in the human psyche. This, even though meta analysis world wide for decades and across multiple health disciplines proves the fallacy of this commonly held belief. Psychiatric deterioration is a 24/7-365 day fact. The sad reality is that modern office psychiatry is only available 8 to 5 Monday to Friday while emergency departments are burdened with psychiatric patients during off hours and weekends thus generating the whole full moon fallacy. I blame ancient Romans who named their worshipped moon-goddess “Luna”, the origin of the phrases lunacy and lunatic as the initiators of this trend. The reality behind this mythology is the ongoing problem of psychiatric patients not taking their anti-psychotic drugs because of the side effect events, unbalanced dosage and the sheer volume effect of too many patients overwhelming understaffed psychiatric facilities. I am categorically certain every health professional at some point has lamented the lack of a delivery system that would compel psychiatric patients to take their drugs. Right now such forced compliance can only take place with a court order, and usually only after some sort of physical confrontation with an often paranoid non-compliant patient. It’s a flawed system requiring police to track down street people; again typically only after objectionable behaviour brings the person to the attention of the authorities. It’s become a turnstile health delivery system in which patients are forced to take medication, but then retreat from medication and then revert to socially unacceptable behaviour thus repeating the police, emergency room, FORM admissions and Court rulings cycle at great public expense.
As of October 2017, the American FDA has approved the distribution of a new drug– ABILIFY MYCITE. This Ingestible Event Marker functions like a battery which broadcasts an electric signal when activated by stomach acid contact. The signal is received by an adhesive patch worn on the skin which in turn transmits the data to your smart phone APP. The patient, when able, is also capable of adding subjective information regarding general health issues, mental status and possible side effect events thus providing health providers real time tracking of compliance.
ABILIFY is an established medication for schizophrenia amongst other common mood disorders and so I see great opportunities for selected patients to improve their level of function and reduce the repetitive turnstile phenomenon. Obviously, this system is in an infancy stage though I see a tangible upside It is expensive and at present, I see that being the sole limiting factor.
My long term concerns are the loss of individual privacy. A system with this level of sophistication requires the use of digital media technology translating into a loss of confidentiality as this very personal data gets uplinked in to that nebulous “cloud” now seemingly and endlessly storing everything on everyone. Fortunately, we are not yet living in a totalitarian society where government forces compliance on everyone for its own tracking purposes. Or are we?
Dr. David Carl