Prescription Practices, Anti-Psychotics, and COVID-19: An Intersectional Examination of the Long-Term Care Home Setting in Canada

Public discourse and concern over the state of long-term care homes in Canada has been ongoing over the last two decades. One of the main sources of these concerns is the off-label prescription of anti-psychotic medications to long-term care home residents. Off-label use of pharmaceuticals is common and can be beneficial in certain contexts, however, there is a risk of anti-psychotics being used as an inappropriate means of managing patients chemically in the long-term care home setting. This paper engages in three lines of inquiry: first, the regulatory landscape of on and off-label prescription in Canada; second, the off-label use of anti- psychotics in long-term care, and specifically, why they are used, why they should not be used, and the impact COVID-19 had in increasing their use; and third, the legal implications of these practices and potential alternatives avenues. This paper ultimately highlights the dangers of off-label prescription in the long-term care setting and advocates for cultural and institutional changes to protect elderly Canadians in these facilities.