In the period 1989-1991 the Medical Tribunal in the state of New South Wales conducted enquiries into seven complaints about professional misconduct of a sexual nature incidental to psychiatric treatment. This study is submitted in the interests of patients, profession and public in accordance with the ethos of the Medical Practitioners Act (NSW). It is based on personal observations and published legal documents and refers to the legal context and procedures. It addresses the substance and style of complaints and complainants and of defences and respondents. The names of six psychiatrists and one trainee psychiatrist were removed from the Medical Register. In three instances decisions or orders were unsuccessfully appealed in the Supreme Court. In two instances associated complaints (of illicitly prescribing drugs of addiction and of divulging confidential information) were also found to be professional misconduct. Courtroom pitfalls are illustrated and practical principles explicit in judgements are reiterated.
This article examines problems and issues of the juvenile justice and drug & alcohol systems in the context of treatment resistant, substance dependent, delinquent youth. The evaluation research on traditional medical model treatment shows high drop‐out and relapse rates along with limited impact on polydrug users. Outdoor challenge programs are reviewed as an alternative within the context of Opponent‐Process Theory and the therapeutic use of stress. These forms of stressful challenge may produce improved self‐esteem and positive affect which may be useful as alternative forms of substance abuse treatment, especially for resistant delinquent youth who have not benefitted from more traditional forms of treatment.
A major drug of abuse today is 3,4-Methylenedioxymethamphetamine (MDMA or 'ecstasy'). Serious medical complications and neurotoxicity are known to be caused from its uncontrolled use, but most long-term effects are still unkown. Neuropsychological studies show cognitive deficiencies in chronic users [1].In March 1999, a 22-year-old man with a 3 year history of drug abuse was admitted to our detoxification ward. Childhood and education were without major complications. He had been taking cannabis since 1996 and 'ecstasy' tablets almost daily since 1997. He documented in his diary the ingestion of more than 350 'ecstasy' tablets in 18 months (up to eight tablets at
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