1. Addiction in the Glasgow Forensic Community Mental Health Team Dr Laurence Tuddenham Consultant Forensic Psychiatrist Glasgow FCMHT Dr Laurence Tuddenham Consultant Forensic Psychiatrist Glasgow FCMHT

2. Alcohol and drug status of homicide accused, Scotland, 2011-12

4. Our patients "Typical" forensic cases About 60 patients – 1/3 rd 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

5. 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

6. Management of substance misuse Differences between services:  Different philosophies and goals  Communication  Medical involvment