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"Psychiatry
and the law are irreversibly entwined. As the practice
of addiction psychiatry becomes increasingly involved
in the treatment of court-mandated patients, it is
important for addiction psychiatrists to familiarize
themselves with the law to appreciate how they can
use it to their patients' benefit. We suggest that
addiction psychiatrists can profit from the forensic
psychiatry model, where court-mandated treatment of
involuntary patients is the standard and is usually
successful. We suggest that drug courts, bringing
together clinical and legal professionals in the most
integrated approach to addiction treatment yet attempted,
offer a promising mechanism for the successful treatment
of the most difficult of these patients" (Hardy,
Patel, & Paull, 2000, p. 574).
"The
individual is not completely guilty or absolved from
criminal or civil responsibilities because of addictive
disease. Increasingly, alcohol and drug disorders
are considered the root causes of criminal and civil
violations that can be ameliorated or eliminated through
therapeutic actions sanctioned and monitored by the
courts" (Miller, 2001, p. 609).
"The
forensic psychiatrist and the generalist should acquaint
themselves with the efficacy of addictions treatment
and the importance and advantages of identifying addictive
diseases in their patients. They must also consider
the legal consequences for not informing patients
of the treatment options for their addictions"
(Miller, 2001, p. 609).
"The
Rehabilitation Act of 1973 and the Americans with
Disabilities Act of 1990 have provided broad protection
for individuals with physical and mental impairments.
These acts provide precedent for inclusion of alcohol
and drug addiction as a disability. An employee with
an alcohol problem, drug problem, or both (which can
apply to illegal drugs if in treatment and not using
them) can be offered accommodation in the form of
addiction treatment before losing his or her employment.
An alcoholic is entitled to the option of addiction
treatment to perform the essential functions of a
particular job. An alcoholic who refuses treatment
can be terminated from his or her position, especially
if unable to perform his or her functions due to continued
alcohol use. However, court decisions have made some
distinctions as to how these acts can be applied to
individual cases.70-77" (Miller, 2001, p. 609).
"Substance
abuse among the offender populations has been well
documented. The nature and extent of substance abuse
among the sub-population of mentally ill offenders
has not been thoroughly explored and is the subject
of this report" (Chiles et al, 1990, p. 1132).
"Compared
with the general population, offenders were five to
30 times more likely to be given a psychiatric diagnosis.
These reports support the hypothesis that rates of
the psychiatric illnesses studied are higher in an
offender population than in the community" (Chiles
et al, 1990, p. 1132).
"Both
mentally Ill offenders with a diagnosis of alcohol
abuse or dependence and those without that diagnosis
had problems with alcohol at an early age. About half
of each group reported that they had problems with
drinking before age ten" (Chiles et al, 1990,
p. 1133).
"Marijuana,
cocaine and amphetamines were the three drugs used
most extensively both by offenders with a diagnosis
of drug abuse and/or dependence and by those that
did not have this diagnosis" (Chiles et al, 1990,
p. 1133).
"Previous
studies have found that drugs and alcohol are available
in prisons and substance abusers have identified frequent
use of alcohol or drugs while incarcerated" (Chiles
et al, 1990, p. 1133).
"The
findings that substance abuse and dependence are part
of the lives of most mentally ill offenders, has important
implications for the development of policies about
compulsory substance abuse treatment of incarcerated
offenders and for the design of treatment plans for
mentally ill inmates" (Chiles et al, 1990, p.
1133).
"Correctional
officers need training in the areas of substance abuse,
mental illness and dual diagnosis" (Chiles et
al, 1990, p. 1133).
"Between
1840 and 1900, European and American medical journals
published over 100 articles on the therapeutic use
of the drug known then as 'cannabuis indica' or (Indian
hemp) and known now as marijuana. It was recommended
as an appetite stimulant, muscle relaxant, analgesic,
hypnotic, and anticonvulsant" (Grinspoon, 1995,
p. 1875).
"In
1913 Sir William Osler recommended it as the most
satisfactory remedy for migraine" (Grinspoon,
1995, p. 1875).
"Today
the almost 5000 year medical history of marijuana
has been almost forgotten. It's use declined in the
20th century because the potency of the preparation
was variable, responses to oral ingestion were erratic,
and alternatives became available- the injectable
opiates and later synthetic drugs such as aspirin
and barbiturates" (Grinspoon, 1995, p. 1875).
"The
Marijuana Tax Act of 1937 was designed to prevent
non-medical uses, this law made cannabis so difficult
to obtain for medical purposes that it was removed
from the pharmacopeia. It is now confined to Schedule
I under the Controlled Substance Act as a drug that
has a high potential for abuse, lacks an accepted
medical use and is unsafe for use under medical supervision"
(Grinspoon, 1995, p. 1875).
"In
1972, the National Organization for the Reform of
Marijuana Laws petitioned the Bureau of Narcotics
and Dangerous Drugs, later renamed the Drugs Enforcement
Administration (DEA), to transfer marijuana to Schedule
II so that it could be legally prescribed" (Grinspoon,
1995, p. 1875).
"In
1988, the DEA declared that marijuana in its natural
form fulfilled the legal requirements for currently
accepted medial use in treatment in the United States"
(Grinspoon, 1995, p. 1875).
"But
the order for marijuana to be transferred to Schedule
II was overruled and the DEA themselves issued a final
rejection for all pleas for reclassification in 1992"
(Grinspoon, 1995, p. 1875).
"Meanwhile
a few patients have been able to obtain marijuana
legally for therapeutic purposes. Since 1978, legislation
permitting patients to use marijuana with a physician
approval has been enacted in 36 states"(Grinspoon,
1995, p. 1875).
"A
public health approach reinforces the need to examine
critically the national drug control strategy, which
emphasized incarceration and a method of controlling
the supply of illicit drugs and to treat drug abuse.
This policy should be reconsidered because the human
and fiscal cost of imprisonment may be more than the
benefit derived for society" (National Commission
of Correctional Health Care, 1992; Glaser & Greifinger,
1993, p. 143).
"Much
of the increase in the jail and prison population
in recent years can be attributed to the nationwide
public policy of mandatory sentencing for drug offenders"
(Glaser & Greifinger, 1993, p. 139).
"Alcohol
and drug- related crimes of epidemic proportions and
changes in sentencing laws explain the phenomenal
growth trend of the incarcerated populations in the
US" (Goldkuhle, 1999, p. 40).
"About
three quarters of all prisoners can be characterized
as involved with alcohol or drugs abuse in the time
leading up to their abuse" (U.S. Department of
Justice, 1998; cited in Goldkuhle, 1999, p. 40).
"The
law, "three strikes you are out", brought
stiffer sentences for substance abuse violations"
(Goldkuhle, 1999, p. 40).
"Medicolegal
officials have provided a preventive role by examining
the role of alcohol in deaths. Medical Examiners studied
the role of alcohol in deaths from a variety of causes.
The result of their studies along with the statistics
on deaths caused by drunken drivers as been a cornerstone
of much of the recent nationwide campaign to decrease
alcohol consumption and eliminate drunken driving"
(Henson, 1987, p. 81).
"Medical
units in the United States treat a number of patients
with cancer and AIDS who use marijuana at home to
relieve symptoms. They often want to continue the
practice while in hospital - but marijuana is illegal"
(Mathre, 1997, p. 23).
"In
addiction nursing, the definition of addiction includes
three components: a compulsion to use; loss of control
of use; and continued use despite negative consequences"
(Mathre, 1997, p. 23).
"Given
the high rate of recidivism for drug offenders, forced
stoppage of drug use appears to provide very little
assistance in maintaining a drug free lifestyle (Rynerson,
1989, p. 12).However
psychiatric nurses have excellent opportunities to
promote emotional health and skill building through
individual and group counseling while inmates are
incarcerated" (Rynerson, 1989, p. 12).
"The
cultural and philosophical differences of correctional
personnel, inmates and helping professionals must
be considered when negotiating and carrying out the
counseling role in a correctional facility" (Rynerson,
1989, p. 12).
"With
substance abuse inmates, trust, a working alliance,
and self disclosure requires much time, patience and
absolute consistency on the part of the nurse"
(Rynerson, 1989, p. 12).
"A
combined cognitive behavioral and educational approach
to nurse-client relationship therapy provides concrete
data for inmates to learn responsibility for their
own behavior and skills for more effective problem
solving" (Rynerson, 1989, p. 12).
"In
1972, the U.S. National Council on Alcoholism defined
alcoholism as a pathological dependency on ethanol
(Criterim Committee, NCA, 1972) Alcoholism is characterized
by tolerance, physical dependency, and/or pathological
organ changes" (Shkrum, 1990, p. 172).
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Topic
D - Forensic Corrections > Section D.4.0. Forensic Practice/Prevention
> Unit.D.4.5. Addictions Assessment/Treatment
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