Journal of Addiction Research & Therapy
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n recent years psychiatrists, general practitioners and other doctors in forensic settings have faced new challenges due to the
increasing problem of certain medications being used as drugs of abuse. Due to concerns regarding the safety of prescribing in
forensic settings, the Department of Health in the United Kingdom recently published a list of medications that are potentially
at risk of abuse. Two commonly used psychotropic medications, mirtazapine and quetiapine, were classified as posing a high
risk. Mentally disordered offenders often enter prisons having had these medicines already prescribed in the community or are
introduced to these medicines by fellow prisoners. However, there is currently relatively little information about the scale of
these problems. Current research regarding the abuse of quetiapine consists of several case reports but no structured research
using larger samples. Regarding mirtazapine, the available literature consists of prison security reports. Following a systematic
review of the current literature, I conclude that there is very limited knowledge about the possibilities of abuse, dependency and
a withdrawal syndrome with these medications and suggest strategies for further research.
Maciej J. Danilewicz graduated in Medicine from Jagiellonian University in Krakow, Poland in 1997 where he subsequently became a Medical
Lecturer. Upon relocating to the United Kingdom, he worked rehabilitation units in the independent sector, a medium secure forensic hospital and a
Substance Intervention Team in Her Majesty's Prison Service. He graduated in Cognitive Therapy from Oxford University in 2010. Currently, he is a
Consultant Psychiatrist for Glen Care Group UK, an independent sector provider, working in low secure forensic and locked rehabilitation units. His
special interests include recognition, management and treatment of substance misuse in forensic settings.
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