Maciej J. Danilewicz
Glen Care Group, United Kingdom
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. Amongst his special interests is the recognition, management and treatment of substance misuse in forensic settings.
In 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.