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The Royal College of Psychiatrists Improving the lives of people with mental illness

The management of substance misuse detainees in police custody: updated guidelines

Embargoed until 20 November 2011

The Royal College of Psychiatrists has updated its guidelines on the assessment and treatment of people with substance misuse problems who are detained in police custody.

The Guidelines, now in their fourth edition, have been revised by a Working Group chaired by psychiatrist Professor Hamid Ghodse. Professor Ghodse has worked in the field of addictions, mental health policy and medical education for more than 35 years, and was last week presented with an RCPsych Lifetime Achievement Award in recognition of his work. 

Substance Misuse Detainees In Police Custody: Guidelines for Clinical Management are aimed at medical, nursing and pharmaceutical professionals who work with detainees with substance misuse problems. The Working Group included representation from all these professions, and received support from the Department of Health.

The Guidelines recognise that the assessment and treatment of substance misusers present forensic physicians with challenges. The Guidelines stress the importance of good communication, of working closely with custody officers, and of shared responsibility for the safety and care of detainees with substance misuse problems. In particular, the Guidelines stress the importance of:

  • the full participation of forensic physicians in all aspects and at all stages of the healthcare of detainees with substance misuse/dependence
  • providing advice to custody officers and others involved with detainees with substance misuse/dependence
  • comprehensive contemporaneous records
  • appropriate sharing of information in accordance with the law and the General Medical Council's advice on professional confidentiality
  • being aware when making all interventions that the interests of the detainee as a patient is paramount.

Professor Ghodse said: "Addicted individuals should always be cared for and treated without being stigmatised – whatever their personal circumstances. Over the last couple of decades there has been a major increase in substance misuse, and a corresponding increase in the numbers of people detained in police custody who misuse substances. Most of these detainees are vulnerable people.

"It can be difficult to undertake a proper assessment of someone in police custody. However, a detained substance-dependent person who is at risk of complications is entitled to exactly the same quality of healthcare as they would receive in other locations. The overriding principle of care must be their safety, and the treatment of suffering that occurs as a result of substance intoxication or withdrawal."

Professor Ghodse added: "Previous editions of the Guidelines have been very well received by all those who deal with detainees in police custody, and we hope they will find the fourth edition just as helpful." 

For further information, please contact:
Sarah Nevins
Press & Social Media Officer
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Claire McLoughlin
Media & Communications Manager 
Telephone: 020 3701 2544
Out of hours contact number: 07860 755896



CR169: Substance Misuse Detainees In Police Custody: Guidelines for Clinical Management (3rd edition)


Note to editors:

The Working Group included representation from the Faculty of Forensic and Legal Medicine at the Royal College of Physicians of London, the Royal College of Psychiatrists, the Royal College of General Practitioners, the College of Emergency Medicine and the Association of Chief Police Officers. The group included officials from the Home Office and Department of Health (who consulted with officials of the devolved administrations in contributing to the work of the group).


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