The identification and treatment of opiate users in police custody

All detainees admitted to seven London police stations were observed over a six-month period (n=2,947). Four per cent were identified as opiate users, although the actual percentage is likely to be much higher. Compared to th e general population of detainees there were significantly more women among known opiate users and this group also contained a higher percentage of wh ite detainees and people born in the British isles. People born in continen tal European countries were also overrepresented. A little more than half o f known users did not reveal their use on arrival at the police station. At least 60% of known opiate users remained well throughout their detention, 30% were intoxicated through drugs at the time of their arrest, but only 13 % displayed signs or symptoms of withdrawal during their detention. Overall , 65% of the known opiate users were seen by a police surgeon and of these 52% were given medication. All of those withdrawing were given drug treatme nt, but most of those who were intoxicated by opiates, or who remained well throughout their detention, received no medication. Of those given medicat ion 86% received an opiate, dihydrocodeine being the commonest preparation, usually in association with a benzodiazepine. Despite the adoption of diff ering management paradigms among police surgeons, the actual medical treatm ent of opiate-using detainees was pragmatic and determined by individual ne ed.