- Email: [email protected]
Custodial Drug Guide Medical Management of People in Custody with Alcohol and Drug Problems
Journal of Clinical Forensic Medicine (2002) 9, 159
BOOK REVIEW
and references as well as a number of scales such as the Glasgow Coma Scale, AUDIT, MAST, and CAGE. The Guide is very clearly set out and easy to read. There is excellent use of colour in pictures and in the text and tables to highlight important areas. The most useful section is part one on drug information. Each substance is described in terms of product information, identification and appearance, uses, psychopharmacology including short and long term use, tolerance, dependence including the DSM IV criteria and interaction with other drugs. Part two stresses the importance of a thorough and well documented assessment to establish the degree of substance misuse; assess the level of current intoxication, the associated risk and required intervention; establish the level of dependence and plan withdrawal treatment; and assess the possibility of drug interactions. Management of overdose and the principles for management of various withdrawal syndromes including alcohol, benzodiazepine and opioid. It is interesting to note that a permit is required to prescribe opioids to an addicted person and the use of opioids to treat opioid withdrawal is felt to be not suitable within the custodial setting and symptomatic treatment is preferred. However detainees on methadone maintenance are permitted to continue their treatment. Smoking is not permitted in custody and therefore the use of nicotine replacement therapy in the form of patches is discussed. Although this Guide does not cover the possible impact of substance misuse on fitness for interview, for the practical information on the various drugs it is an excellent resource for forensic practitioners and comes thoroughly recommended. For more information including a copy of the Guide contact Dr Foti Blaher ([email protected]).
Custodial Drug Guide Medical Management of People in Custody with Alcohol and Drug Problems Dr. Edward Ogden, Ms. Dimitra Petroulias, and Dr. Foti Blaher. Published by Victoria Police 2001. The Victoria Police Custodial Medicine Unit (CMU) has been in operation since 1st October 1995. The Custodial Drug Guide was developed to provide a resource to assist doctors and nurses within the CMU manage problems related to alcohol, tobacco and other drugs. The introduction states that the guidelines establish ‘‘good clinical practice’’ and management of the drug-related conditions most commonly encountered in custody. The Guide therefore has similar aims to ‘‘Substance Misuse Detainees in Police Custody Guidelines for Clinical Management’’ (June 2000) by the Association of Police Surgeons and the Royal College of Psychiatrists. There is no doubt that substance misuse problems in detainees in police custody is a significant problem. The Guide quotes a survey in 1998 which found that 46% of Australians aged 14 years and above have used illicit drugs some time in their lives. Figures from the British Crime Survey published in 1999 give lifetime ‘ever’ use in those aged between 16–59 years at 32% but with young people having the highest rates of consumption. Furthermore a report of the Victorian Premier’s Drug Advisory Council ‘‘Drugs and Our Community’’ in 1996 estimated that 69% of custodial prisoners have a lifetime diagnosis of drug problems. There are four parts to this Guide. Part One contains information on the various psychoactive drugs – depressants, stimulants and hallucinogens, including identification and appearance, pharmacological properties and effects of short and long-term use. Part two entitled Medical Management of Alcohol and Drug Problems describes the features of withdrawal of psychoactive drugs and the management of intoxication and withdrawal. It includes information about screening and assessment of alcohol and drug-related conditions, emergency management and effective withdrawal treatment within the custodial setting. Part three is a summary of drug education and medical management and part four includes appendices and other general information including relevant phone numbers (for Victoria), street language
M. M. STARK ‘Brandywell’ 52 Christ Church Mount, Epsom KT19 8NB, Surrey UK E-mail address: [email protected]
doi:10.1016/S1353-1131(02)00042-1, available online at http://www.idealibrary.com on
159
BOOK REVIEW
and references as well as a number of scales such as the Glasgow Coma Scale, AUDIT, MAST, and CAGE. The Guide is very clearly set out and easy to read. There is excellent use of colour in pictures and in the text and tables to highlight important areas. The most useful section is part one on drug information. Each substance is described in terms of product information, identification and appearance, uses, psychopharmacology including short and long term use, tolerance, dependence including the DSM IV criteria and interaction with other drugs. Part two stresses the importance of a thorough and well documented assessment to establish the degree of substance misuse; assess the level of current intoxication, the associated risk and required intervention; establish the level of dependence and plan withdrawal treatment; and assess the possibility of drug interactions. Management of overdose and the principles for management of various withdrawal syndromes including alcohol, benzodiazepine and opioid. It is interesting to note that a permit is required to prescribe opioids to an addicted person and the use of opioids to treat opioid withdrawal is felt to be not suitable within the custodial setting and symptomatic treatment is preferred. However detainees on methadone maintenance are permitted to continue their treatment. Smoking is not permitted in custody and therefore the use of nicotine replacement therapy in the form of patches is discussed. Although this Guide does not cover the possible impact of substance misuse on fitness for interview, for the practical information on the various drugs it is an excellent resource for forensic practitioners and comes thoroughly recommended. For more information including a copy of the Guide contact Dr Foti Blaher ([email protected]).
Custodial Drug Guide Medical Management of People in Custody with Alcohol and Drug Problems Dr. Edward Ogden, Ms. Dimitra Petroulias, and Dr. Foti Blaher. Published by Victoria Police 2001. The Victoria Police Custodial Medicine Unit (CMU) has been in operation since 1st October 1995. The Custodial Drug Guide was developed to provide a resource to assist doctors and nurses within the CMU manage problems related to alcohol, tobacco and other drugs. The introduction states that the guidelines establish ‘‘good clinical practice’’ and management of the drug-related conditions most commonly encountered in custody. The Guide therefore has similar aims to ‘‘Substance Misuse Detainees in Police Custody Guidelines for Clinical Management’’ (June 2000) by the Association of Police Surgeons and the Royal College of Psychiatrists. There is no doubt that substance misuse problems in detainees in police custody is a significant problem. The Guide quotes a survey in 1998 which found that 46% of Australians aged 14 years and above have used illicit drugs some time in their lives. Figures from the British Crime Survey published in 1999 give lifetime ‘ever’ use in those aged between 16–59 years at 32% but with young people having the highest rates of consumption. Furthermore a report of the Victorian Premier’s Drug Advisory Council ‘‘Drugs and Our Community’’ in 1996 estimated that 69% of custodial prisoners have a lifetime diagnosis of drug problems. There are four parts to this Guide. Part One contains information on the various psychoactive drugs – depressants, stimulants and hallucinogens, including identification and appearance, pharmacological properties and effects of short and long-term use. Part two entitled Medical Management of Alcohol and Drug Problems describes the features of withdrawal of psychoactive drugs and the management of intoxication and withdrawal. It includes information about screening and assessment of alcohol and drug-related conditions, emergency management and effective withdrawal treatment within the custodial setting. Part three is a summary of drug education and medical management and part four includes appendices and other general information including relevant phone numbers (for Victoria), street language
M. M. STARK ‘Brandywell’ 52 Christ Church Mount, Epsom KT19 8NB, Surrey UK E-mail address: [email protected]
doi:10.1016/S1353-1131(02)00042-1, available online at http://www.idealibrary.com on
159