The Identification and Treatment of Opiate Users in Police Custody

Pearson, Richard; Robertson, Graham; Gibb, Robert

doi:10.1177/002580240004000405

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…Complexity and mixed pathology across domains have emerged as key themes (Rekrut-Lapa & Lapa, 2014;McKinnon & Grubin, 2010;PayneJames, Green, Green, McLachlan, Munro & Moore, 2010). High levels of substance use and dependence have been identified, with a wide range of substances (both legal and illegal) being consumed, and serious problems arising in police stations as a consequence of both substance intoxication and withdrawal (Clement, Gerardin, Victorri, Guigand, Wainstein & Jolliet, 2013;Dorn, Ceelen, Buster, Stirbu, Donker & Das, 2014;Coulton, Newbury-Birch, Cassidy, Dale, Deluca, Gilvarry, Godfrey, Heather, Kaner & Oyefeso, 2012;Payne-James, Wall & Bailey, 2005;Pearson, Robertson & Gibb, 2000). Substance use also plays an important role in deaths and near miss incidents in police custody suites (Best, Havis, Payne-James & Stark, 2006).…”

Section: Introductionmentioning

confidence: 99%

Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals

Forrester

Samele

Slade

et al. 2016

The Journal of Forensic Psychiatry & Psychology

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The 43 police forces in England and Wales have made over 13 million arrests in the last decade. Yet despite this high volume criminal justice system activity, and evidence of substantial health morbidity across the criminal justice pathway, mental health services in police custody have so far only been developed in patches, and the literature in this area is limited. Referrals (n=1092) to a pilot mental health service operating across two police stations in a London borough were examined over an 18-month period in 2012/13. The referred group had high levels of mental health and substance misuse problems (including acute mental illness, intoxication and withdrawal), selfharm, suicide risk and vulnerability, with some important gender differences. Although this work has limitations, the findings are broadly consistent with the small existing literature and they confirm the need for services that are sufficiently resourced to meet the presenting needs.Abstract word count = 145

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Section: Introductionmentioning

confidence: 99%

Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals

Forrester

Samele

Slade

et al. 2016

The Journal of Forensic Psychiatry & Psychology

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“…Pearson et al (2000) found the mean age of 115 detainees to be 29 years, with the proportion of women at 28%. In our sample, the mean age was 28 years and 27% were women.…”

Section: Discussionmentioning

confidence: 99%

Contact with treatment services among arrested drug users

et al. 2003

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Aims and Method To identify the proportion of arrested drug misusers with prior contact with treatment services, police surgeons' records were examined over a 12-month period and compared with the records of the local drug misuse services. Both referrals and those who attended with face-to-face contact were noted. Results Sixty-seven per cent of drug-related cases had been referred to services prior to arrest and 58% had attended with face-to-face contact on at least one occasion. Homeless and male drug users were more likely to have had no past contact. Police surgeons treated three-quarters of the cases for opiate dependence. Drug misusers were much more likely to have had past contact with services than arrested alcohol misusers, and were more likely to reoffend. Clinical Implications The evidence base for motivational enhancement in the transient coercive setting of police custody is not established, and arrest referral schemes might not be cost-effective in areas where most cases have had previous contact with services. Local research may contribute to more informed decisions about these treatment-related criminal justice initiatives.

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“…[11] pointed out that 26% of pharmacists in Scotland dispensed DHC and Pearson et al . [12] observed that DHC is the most common medication given to opiate misusers to manage opiate withdrawal symptoms in police custody in seven London areas.…”

Section: Introductionmentioning

confidence: 99%

Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007

Zamparutti

Schifano

Corkery

et al. 2011

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Dihydrocodeine (DHC) is an opioid analgesic sometimes prescribed as an alternative to other medications (e.g. methadone and buprenorphine) for opioid misuse. Its effectiveness is, however, still controversial. • DHC prescription rates seem to be related to levels of DHC fatalities, possibly in relation to levels of disregard of the availability of supervised or interval dispensing of opioids, but no large‐scale analysis of DHC fatalities has been carried out. • We analysed here involvement of DHC in fatalities that occurred between 1997 and 2007 among individuals with a history of opiate/opioid misuse reported to the National Programme on Substance Abuse Deaths (np‐SAD). WHAT THIS STUDY ADDS • DHC, either alone or in combination, was identified in 584 fatalities. Typical cases identified were males in their early thirties. In accidental overdoses, DHC, which had been prescribed to 45% of the victims, was typically identified in combination with other drugs, such as heroin/morphine, methadone and hypnotics/sedatives. Both paracetamol and antidepressants were more typically identified in combination with DHC in suicides. • Opiate/opioid misusers should be educated about risks associated with polydrug intake and prescribers should carefully consider a pharmacological intervention alternative to DHC (e.g. methadone, buprenorphine) when managing and treating opiate addiction. AIMS Although its effectiveness is somewhat controversial, it appears that dihydrocodeine (DHC) is still prescribed in the UK as an alternative to both methadone and buprenorphine for the treatment of opiate addiction. METHODS Data covering the period 1997–2007 voluntarily supplied by coroners were analysed. All cases pertaining to victims with a clear history of opiate/opioid misuse and in which DHC, either on its own or in combination, was identified at post‐mortem toxicology and/or implicated in death, were extracted from the database. RESULTS Dihydrocodeine, either alone or in combination, was identified in 584 fatalities meeting the selection criteria. In 44% of cases it was directly implicated in the cause of death. These cases represented about 6.8% of all opiate/opioid‐related deaths during this period. Typical DHC cases identified were White males in their early thirties. Accidental deaths (96%) were likely to involve DHC in combination with other psychoactives, mainly heroin/morphine, hypnotics/sedatives and methadone. Both paracetamol and antidepressants were found in proportionately more suicide cases than in accidental overdoses. DHC had been prescribed to the decedent in at least 45% of cases. CONCLUSIONS Opiate/opioid misusers should be educated about risks associated with polydrug intake. More in particular, co‐administration of DHC with heroin, methadone and benzodiazepines may increase the risk of accidental fatal overdose. Prescribers should carefully consider pharmacological intervention alternative to DHC (e.g. methadone, buprenorphine) when managing and treating opiate addiction. Mo...

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The Identification and Treatment of Opiate Users in Police Custody

Cited by 12 publications

References 4 publications

Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals

Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals

Contact with treatment services among arrested drug users

Deaths of opiate/opioid misusers involving dihydrocodeine, UK, 1997–2007

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