title: The clinical management of substance misusers in police custody -- a survey of current practice.
abstract: Large numbers of substance misusers are seen in police custody. Their management remains a significant part of a forensic physician's workload. Substance misuse, including alcohol, is a factor in a substantial number of deaths in custody. Guidelines have been produced on the acceptable minimum standards for assessment and treatment. The aims of this study were to determine the current attitudes and practice of forensic physicians to see whether there had been any change in practice since their publication. The results suggest that the majority of respondents had read the guidelines. However, there were still considerable variations in practice and circumstances where the minimum standards were not being achieved. Whilst 90% of respondents felt confident in dealing with substance misusers, many commented that further information on specific drugs and further training on management of substance misusers would be beneficial.
authors.affiliation: The Forensic Medicine Unit, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, United Kingdom. stark@cheam.demon.co.uk
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Stark
authors.forename: Michael
authors.initials: M
authors.lastname: Gregory
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D003061:Codeine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D005554:Forensic Medicine; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D009294:Narcotics / Q000627:therapeutic use; D016495:Police; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011329:Prisoners; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000701:Analgesics, Opioid; D009294:Narcotics; C014481:dihydrocodeine; D008691:Methadone; D003061:Codeine