Evaluation of problematic psychoactive substances use in people placed in police custody |
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| Institution: | 1. Clinical Pharmacology Department, Institute of Biology, CHU de Nantes, 9 Quai Moncousu, 44093 Nantes Cedex 01, France;2. Laboratory of Forensic Medicine, Faculty of Nantes, 1 Rue Gaston Veil, 44035 Nantes, France;1. Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford, California;2. Primary Care Outcomes Research, Stanford University, Stanford, California;3. Division of General Pediatrics, Department of Pediatrics, Stanford University, Stanford, California;4. Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina;5. Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California;6. Department of Emergency Medicine, Stanford University, Stanford, California;1. Mental Health and Criminal Justice, Royal Holloway, University of London, UK;2. Health Intelligence at Glyndwr University, UK;3. IHWUK, UK;1. Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona;2. University of Arizona Cancer Center, Tucson, Arizona;3. Maricopa Correctional Health Services, Phoenix, Arizona;4. Emeritus Professor of Surgery, Mayo College of Medicine, Rochester, MN;1. David Geffen School of Medicine at UCLA, Department of Medicine; 911 Broxton Avenue, 1st Floor, Los Angeles, CA 90024, United States;2. Charles R. Drew University, Department of Psychiatry and Human Behavior, 1731 E. 120th Street, Los Angeles, CA 90059, United States;3. Charles R. Drew University, Masters of Public Health Program, 1731 E. 120th Street, Los Angeles, CA 90059, United States;4. County of Los Angeles, Department of Health Services, Division of HIV and STD Programs, 600 S. Commonwealth Ave., 19th Floor, Los Angeles, CA 90005, United States;5. Inland Empire Health Plan, 10801 Sixth Street, Suite 120, Rancho Cucamonga, CA 91729, United States;6. UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles E. Young Dr. South, 16-035 Center for Health Sciences, Los Angeles, CA 90095-1772, United States;1. Department of Forensic Medicine, Forensisch Artsen Rotterdam Rijnmond (FARR), The Netherlands;2. Department Psychiatry, GGZ Centraal, Almere, The Netherlands;1. Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, Korea;2. Department of Health Education and Management, Ewha Womans University, Seoul, Korea;3. Juvenile Division, Ministry of Justice, Seoul, Korea;4. Korea Association of Health Promotion, College of Medicine, Seoul National University, Seoul, Korea |
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| Abstract: | Introduction and aimsIn France, the law states that any person held in custody could be examined by a doctor. The main objective of the medical examination is to give medical evidence of health compatibility with custody. This review identifies health risks such as addictive behaviour. We wanted to know which psychoactive substances are used in this particular population, and how problematic these uses are.Design and methodsA prospective, monocentric, open-ended study conducted via a structured questionnaire was carried out on detainees who reported having taken drugs or illegal substances. Practitioners investigated desired effects for each substance, and characteristics of use, by means of the dependence criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (American Psychiatric Association, 1994). Problematic use was assessed when at least 3 items of the DSM IV were positive.Results604 questionnaires were examined. 90.7% of questionnaires reported tobacco use, 76.2% cannabis, 57.3% alcohol, 12.5% psychostimulants, 10.0% opiates and 0.7% benzodiazepines or Z-drugs. The frequency of problematic use was 74.6% for opiates, 44.9% for cocaine and 25.3% for cannabis. Compared to non-problematic users, problematic users were older, more likely to be jobless without financial means, more likely to have a medical history, including a greater likelihood of mental illness, and more chance of undergoing prescribed medical treatment. They included more women and more homeless people.Discussion and conclusionsThese results show characteristics of psychoactive substance use in a sample of people in custody. Psychoactive substances mentioned by respondents are not different from those observed in the general population, but for certain users, the desired effects are far from the pharmacologically expected ones. For some, taking substances seems to be part of their way of life, for others it is a means to compensate for an underlying feeling of uneasiness. Furthermore, problematic users present severity criteria which seem to be greater than in psychoactive substance users in the general population. |
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| Keywords: | Street drugs Psychotropic drugs Substance related disorders Police custody Forensic Medicine |
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