much. Thanks for your work. Thank you. An investigation by
the AP and PBS frontline revealed police and medics using
injected sedatives to de-escalate people who have been
deemed to have something called excited delirium.
>> We've now come to understand that excited delirium is a
deeply flawed concept in many cases, the definition of excited
delirium is built on racial stereotypes and probably more
fundamentally, excited. Delirium was a concept that, in many of
these cases, served to shift the focus from the actions of the
first responders. Restraint or chemical sedation by the police
or by EMS to the individual for using methamphetamine, for
engaging in criminal activity, for, in some cases, suffering
from mental health emergencies. >> The use of medications is
part of an excited delirium protocol in some departments to
render the person compliant. This is often in combination
with stun guns and pinning subjects face down, but the
combination can be fatal. It happened to a man in Eau Claire
County, as described in the investigative reporting excited
high pain tolerance and superhuman strength, is a
controversial and disputed diagnosis and should not be used
to justify use of force and medication given. That's
according to our next guest psychiatrist, Doctor Julie Owen
from the Medical College of Wisconsin. And doctor, thanks
for joining us. >> Why do you say that excited
delirium is a disputed diagnosis .
to be described in the 1980s, and that was in conjunction with
, a rising cocaine use and there are very few, professional
medical organizations that delirium as a diagnosis. And
without that recognition and without that consensus of the
medical community, there's been a lack of true diagnostic
criteria that folks agree on, when using this term, which has
called its use into dispute. >> So if it's if it's not
excited delirium, what are police and first responders and
medics responding to in the field that that then have them
using these injected sedatives. >> So oftentimes, as an
individual who might be described as displaying features
of, what has been come to known as be known as excited delirium,
they will look extremely agitated and, they will
potentially be behaving in a bizarre manner, the literature
that has looked at this, syndrome has described, things
like increased pain tolerance, the individual looking sweaty,
the individual breathing rapidly. An individual who looks
like they're they don't really get tired despite a lot of
physical exertion. And sometimes, the literature also
describes individuals who are not necessarily complying with
law enforcement official orders. And or being inappropriately
clothed in your research, what did you find about the outsized
diagnosis of this excited delirium in black or brown
police subjects? Usually there's a, a skewing of the use of this
term with, young men and young men of color, and young men of
color, who probably at a later phase of examination, are found
to be utilizing some sort of, what we call sympathomimetic or
a stimulant like substance. >> So the front line
investigation is narrowed in on the use of injected drugs like
ketamine by police and medics. What's your view of that? Use
>> I work in the hospital setting. In the hospital
setting, if an individual presents with agitated Bryan,
typically the best accepted practice is as a physician to
evaluate that person and try to determine what is the most
likely cause of that person's agitation. And medications are
used as a tool then to treat and relieve that person of that
agitated state. So the use of medications is in and of
themselves, is not necessarily problematic. It's the use of a
medication with oftentimes very incomplete data and with
differing protocols, and dosing. And again, sort of starting with
that, not truly a medical diagnostic term, to sort of
drive the intervention or the choice of the intervention that
seems to be problematic in these cases.
>> How troubling is it to you that excited delirium might be
used as a justification for use of force or injections of
ketamine? >> It is troubling, and again, I
think, you know, as a physician and, and as a physician who
practices in solely emergent or acute settings, this sort of
case is hard for somebody like myself, to try to get to the
bottom of and when you have folks who don't have the same
amount of clinical training, sort of throwing out terms that
sound like diagnoses to then drive interventions, with
questionable safety involved and, and of course, when these
interventions result in lethal outcomes, when really that's
probably not necessary. That is disturbing.
>> You say that it is imperative to find consensus bias among
medical professionals around the diagnosis of excited delirium.
Has that yet been found? That consensus? No And are more
people like yourself talking about it?
again, my practice clinically, is working shoulder to shoulder
with emergency medicine physicians and that sort of
cross specialty collaboration, and, collaboration of expertise
in this space. I think that's what's necessary to really, find
again, consensus. But a real clear sense of what it is that
we're trying to accomplish with utilizing terms like this or
trying to catch summarize clinical presentations like