Prison psychiatrist David Craig explains prescribing methods in new article

The psychiatristat Newfoundland and Labrador's largest prison, who has often come under fire for taking inmates off their prescribed medications, has published an articleabout his practices in a Canadian medical journal.

• Prison psychiatrist doing nothing wrong, peer review says

In the Canadian Journal of Addiction released in December, Dr. David Craig said he "sought to reduce the unnecessary prescribing of psychotropic medications with abuse potential," citing medications like Valium, Ritalin and sleeping pills.

In"Swimming against the Tide"Restricting Prescribing Practices in a Prison: A Personal Journey, Craig acknowledgedthat dealing with public criticism for his way of treating inmates has been "difficult."

Despite multiple complaints from inmates and their families, apeer review released in 2012 said Craig metthe standards of care in the psychiatric services he providedto inmates at provincial correctional facilities.

Craig wrote that there has been positive impacts on the well-being of inmates and on health care costs,by reducing "unnecessaryprescribing rates of psychotropic drugs with abuse potential to prison inmates."

Decrease in prison violence

Craig explainedhe would assess the inmatesand would taper them offbenzodiazepines (Valium-like drugs)and HS sedatives (sleeping pills).

Inmates were then allowed no more than one antidepressant and no more than one antipsychotic agent.

As a result of those methods, Craig said health staff noted overall improvement of an inmate's mental health,and prison staff reported a decrease in prison violence.

Craig said he first worked at Her Majesty's Penitentiary during his residency program in 1986 and was concerned over the practice of prescribing sleeping pills, despite the inmate's "abuse potential."

In 1999, when Craig was asked to take over thepsychiatric practice at HMP, he said he warned the director of adult corrections to expect complaints as his approach to prescribing medication was conservative.

'Emotionally challenging' ordeal

Craig saidthat while the peer review approved of his methods, years of complaints and negative stories in the media have not been easy.

"Anybody who is facing a complaint to the licencing body, it's emotionally challenging," Craig told CBC News Wednesday.

"Somebody is basically saying that you're unethical or incompetent. So it is anxiety-inducing until the reports come back."

Craig said that perhaps the hardest part of the situation is that often when people would publicly criticise his work, he would not be allowed to respond to those accusations publicly.

"Basically, you're stuck. Something is said, and youhave to live with it," he said."I had a lot of times when I had nights where I had difficulty sleeping, and times when I wanted to say things."

Craig said there were several times when there werepublic calls for him to be fired, especially from Citizen's Representative Barry Fleming.

"I would argue that, ironically, the citizen's representative turned around and tried to tarnish my reputationand in doing so he violated my rights," Craigsaid.

"I believe there was at least three times where he was in the media calling for my head, and saying I should be fired.Well, as it turned out the peer review said that I was doing a good job."