title: Concealment of drugs by police detainees: lessons learned from adverse incidents and from 'routine' clinical practice.
abstract: This is a collaborative piece of work undertaken between the PCA and a Principal FME. The study is based on 16 cases of internal drug concealment drawn from 43 drug-related deaths in custody in England and Wales between 1997 and 2002. These data are supplemented by three case studies from a county force involving non-fatal drug concealment to illustrate practical custody issues. The majority of the 16 deaths were white (n = 12) and male (n = 13) with a mean age of 34 years. In half of the cases, the deceased was known or believed to have concealed drugs orally at the point of initial contact with police. In 4/16 cases, the individual first showed signs of medical distress in a public place, a further 4 collapsed on arrival at the police station and two more detainees were subsequently found collapsed in their cell. Drug toxicity was the most common cause of death (10/16). In 5 cases death was caused by airway obstruction by swallowed packages. Both cocaine (14/16) and cannabis (8/16) traces were found in post-mortem samples. The report emphasises the need for a safety first approach.
authors.affiliation: Independent Police Complaints Authority, London, UK.
authors.forename: Siobhan
authors.initials: S
authors.lastname: Havis
authors.forename: David
authors.initials: D
authors.lastname: Best
authors.forename: Jane
authors.initials: J
authors.lastname: Carter
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D000662:Amphetamines / Q000032:analysis; D002186:Cannabinoids / Q000032:analysis; D003042:Cocaine / Q000506:poisoning; D003415:Crime; D003679:Deglutition; D018765:Dopamine Uptake Inhibitors / Q000506:poisoning; D004349:Drug Packaging; D005260:Female; D005547:Foreign Bodies / Q000150:complications*; D005554:Forensic Medicine; D006213:Hallucinogens / Q000032:analysis; D003932:Heroin / Q000032:analysis; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000032:analysis; D009294:Narcotics / Q000032:analysis; D016495:Police; D011329:Prisoners; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D000662:Amphetamines; D002186:Cannabinoids; D018765:Dopamine Uptake Inhibitors; D006213:Hallucinogens; D009294:Narcotics; D003932:Heroin; D003042:Cocaine; D018817:N-Methyl-3,4-methylenedioxyamphetamine