Symptoms and Signs of Substance Misuse

Margaret Stark LLM MSc (Med Ed), FFFLM, FACBS, FHEA, FACLM, FRCP, DGM, DMJ, DAB Consultant Forensic Physician; Director of the Clinical Forensic Medicine Unit, NSW Police Force, Sydney, Australia; Adjunct Professor in the Faculty of Medicine of The University of Sydney; Founding Academic Dean of the Faculty of Forensic and Legal Medicine of the Royal College of Physicians of London Jason Payne-James LLM, MSc, FFFLM, FFSSoc, FRCS(Ed & Eng), DFM Mediator Jason Payne-James qualified in medicine in 1980 at the University of London. He is Honorary Senior Lecturer at Cameron Forensic Medical Sciences, Barts & the London School of Medicine & Dentistry, UK. He is external Consultant to the UK National Crime Agency. He has been a Forensic Medical Examiner for the Metropolitan Police Service for over two decades. He is Editor-in-Chief of the Journal of Forensic & Legal Medicine. Forensic medicine clinical and research interests include healthcare of detainees, deaths, harm and near misses in custody, drugs and alcohol. Michael Scott-Ham BSc, MFSSoc Consultant Forensic Toxicologist; Committee Member of the United Kingdom and Ireland Association of Forensic Toxicologists, Member of the Society of Forensic Toxicologists, Member of The International Association of Forensic Toxicologists, Senior Associate Member of the Royal Society of Medicine, Director of Principal Forensic Toxicology and Drugs Consultancy Ltd., London and Director of Principal Forensic Services Ltd, London

Introduction. Routes of administration. Harm reduction and minimisation. Drugs, statutes and legal requirements. The medical and health complications of substance misuse. Suspected internal drug traffickers: drug stuffers and mules. Substance detection. Specific drugs. Alcohol. Aminoindanes, indoles and benzofurans. Amphetamine-type stimulants. Anabolic steroids. Barbiturates. Benzodiazepines. Cannabis. Cocaine. Ecstasy. γ-Hydroxybutyrate and related compounds. Ketamine. Khat. LSD. Nitrites. Opiates/opioids. Phencyclidine. Phenethylamines. Piperazines. Synthetic cannabinoids. Synthetic cathinones. Tobacco. Tryptamines. Volatile substances. ‘Z’ drugs. Appendices. Glossary. Clinical Institute Withdrawal Assessment of Alcohol Scale, revised (CIWA-Ar). Alcohol assessment questionnaires: Brief MAST, CAGE and AUDIT. Clinical Opiate Withdrawal Scale. Further reading/resources. Index.