Peter Dean

Drug misusers in police custody: a prospective survey.

Approximately 11% of individuals seen by forensic medical examiners in police custody in London are drug misusers. This prospective survey using an anonymized structured questionnaire attempted to define some of the characteristics of this selected group of drug misusers. The study was undertaken in Metropolitan Police Service stations (London, UK) within the area covered by Group IV Forensic Medical Examiners. One hundred and fifty consecutive drug misusers in police custody were assessed. Of these individuals 77% used heroin; 30% used both heroin and cocaine regularly; 72% were injecting drugs; 32% were being prescribed drugs (e.g. methadone) by general practitioners or drug agencies. Those individuals prescribed drugs spent a similar amount per day on illicit drugs as those who were not (100.30 pounds versus 106 pounds). Four per cent of individuals were HIV-positive; 25.7% were hepatitis-B positive. Only 9.7% were aware that prophylaxis for hepatitis-B was possible. Seventy-four per cent had served previous prison sentences and of those 82% had used class A controlled drugs whilst serving the sentence. It is concluded that drug misusers seen in police custody tend to be recidivists. It seems that some clear means of identifying and ensuring referral and attendance at an appropriate agency may be the only way to break the cycle of drug misuse, prison and further drug misuse in this highly (self) selected group of patients.

Assault and Injury in Clinical Forensic Medical Practice

A prospective study was undertaken of 150 individuals in police custody, seen by a Forensic Medical Examiner (FME) for documentation of alleged assault and associated injuries. Ninety-six per cent consented to participate in the study of whom 86% were male. The mean age was 29.8 years. Most assaults (35%) were said to be unprovoked, 26% of injuries were alleged to have occurred at the time of arrest, 17% as a result of domestic incidents and 8% due to driving incidents. Twenty-nine per cent of examinees were victims of assault, 21% complained of alleged police assault and 20% were police officers injured during arrests. There was no significant difference between the mean ages of victims and assailants, and no significant difference in the proportions of each group under the influence of alcohol. Those individuals alleging police assault were all male, and significantly more likely to be unemployed and single. Victims of assault were significantly more likely to be female. Weapons were used in only 15% of cases. The head was the most common site of injury. Twenty-three per cent of the study population required hospital assessment. The study has characterized the different groups of individuals requiring medical assessment for assault and injury in police custody. The findings in this study population differ from similar studies undertaken in alternative settings.