Download Dr Laurence Tuddenham

Addiction in the Glasgow Forensic
Community Mental Health Team
Dr Laurence Tuddenham
Consultant Forensic Psychiatrist
Glasgow FCMHT
Alcohol and drug status of homicide accused, Scotland, 2011-12
Our 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 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 misuse
• Differences between services:
 Different philosophies and goals
 Communication
 Medical involvment