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Illicit drug misuse in mental health units

East Midlands Centre for Forensic Mental Health, Arnold Lodge, Cordelia Close, Leicester LE5 OLE, e-mail : milton{at} lineone. net

Ira Unell, Lecturer in Substance Misuse

Leicestershire NHS Drug and Alcohol Service, Drury House, 50 Leicester Road, Narborough, Leicestershire LE9 5DP

Sir : We were interested to read Williams & Cohen's (Psychiatric Bulletin, February 2000, 24, 43-46) reminder of the difficulties for front-line staff in managing the problem of illicit drug use in mental health units. They suggest that "clear procedures to control substance misuse are necessary... for the legal protection of staff" in addition to policies covering patient and visitor searches, consultation with local police and "how far can and should confidentiality be protected".

Their comments are pertinent in light of the recent sentencing of two Cambridgeshire hostel workers to four and five years' imprisonment under the ‘Premises’ section of the Misuse of Drugs Act, which makes it a criminal offence for third parties to knowingly permit heroin or cannabis use in their property, in this case a homelessness day centre (The Guardian, 10 December 1999). Although suspected drug dealers were banned from the centre, staff refusal to give the names of alleged drug users to the police on the basis of confidentiality was seen as ‘deliberately obstructive’ behaviour.

With the reported prevalence of comorbid psychotic and substance misuse disorders being high and with such patients spending longer in hospital (Menezes et al, 1996), legal issues surrounding the presence of alcohol and drugs in mental health units are bound to occur. It would be detrimental to an already (dually) disadvantaged group of patients if staff felt unsure or even afraid of the legal consequences of their management relating to prohibited substances and we too urge trusts to offer clear guidance for the protection of both patients and their staff.

References

MENEZES, P. R., JOHNSON, S., THORNICROFT, G., et al (1996) Drug and alcohol problems among individuals with severe mental illness in south London. British Journal of Psychiatry, 168, 612-619.[Abstract/Free Full Text]

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This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Milton, J. Articles by Unell, I. Search for Related Content PubMed Articles by Milton, J. Articles by Unell, I.