Addiction in the Glasgow Addiction in the Glasgow Forensic Community Mental Forensic Community Mental

Health TeamHealth Team

Addiction in the Glasgow Addiction in the Glasgow Forensic Community Mental Forensic Community Mental

Health TeamHealth Team

Dr Laurence TuddenhamDr Laurence TuddenhamConsultant Forensic PsychiatristConsultant Forensic Psychiatrist

Glasgow FCMHTGlasgow FCMHT

Dr Laurence TuddenhamDr Laurence TuddenhamConsultant Forensic PsychiatristConsultant Forensic Psychiatrist

Glasgow FCMHTGlasgow FCMHT

Alcohol and drug status of homicide accused, Scotland, 2011-12Alcohol and drug status of homicide accused, Scotland, 2011-12Alcohol and drug status of homicide accused, Scotland, 2011-12Alcohol and drug status of homicide accused, Scotland, 2011-12

Our patientsOur patientsOur patientsOur patients

•"Typical" forensic cases

•About 60 patients – 1/3rd restricted, most subject to compulsory conditions

•Personality disorder, serious mental illness and substance misuse

•Substance misuse is more important than mental illness in causing violence

•Substances/alcohol significant role in index offence in 2/3rds of patients

Management of substance misuseManagement of substance misuseManagement of substance misuseManagement of substance misuse

•Focus on prevention or early detcction and intervention

•Prevention – conditions prohibiting substance/alcohol use, compulsory drug/alcohol tests, liable to recall to hospital or prison if breach conditions

•Treatment – if dependent use, referral to specialist addiction service

Management of substance misuseManagement of substance misuseManagement of substance misuseManagement of substance misuse

•Differences between services:

Different philosophies and goals

Communication

Medical involvment