The Alcohol-Intoxicated Person in Custody: Diagnosis, Differential Diagnosis and Management

Abstract

Individuals who are intoxicated with alcohol (most commonly ethanol) will commonly be detained by police for a wide range of offenses. It is essential that custody staff are trained to recognize individuals with alcohol use disorders and comorbid health conditions and request medical assistance as required. Forensic physicians and other health care professionals should perform a comprehensive assessment to diagnose alcohol intoxication and ensure that the detainee is fit to be detained and interviewed by police. Forensic pathologists should be aware of the appropriate clinical management of alcohol-intoxicated persons in custody when involved in death in custody investigations.

Screening for mental disorders in police custody settings

“…The revised Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar) is used in hospital settings to quantify withdrawal symptoms and signs and guide treatment. A score of over 15 indicates an increased seizure risk and is recommended as a cut-off for transfer to hospital for in-patient detoxification (Stark 2014). Its use in police custody has not yet been evaluated, but it may prove to be a valuable tool to minimise risk in detainees with a history of problematic alcohol use.…”