Principles of Addictions and the Law: Applications in Forensic, Mental Health, and Medical Practice

373 Pages·2010·1.58 MB·English

by  Norman S. Miller

Principles of Addictions and the Law
Applications in Forensic, Mental Health, and Medical Practice
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Principles of Addictions
and the Law
Applications in Forensic, Mental Health, and
Medical Practice

Edited by
Norman S. Miller

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First edition 2010

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10 11 12 13 10 9 8 7 6 5 4 3 2 1
Contents
Contributors x v
Preface x vii
1 . The Basic Legal Structure and Organization 1
Anna Baumgras
Introduction : Sources of Law 1
The Judicial Branch 2
Civil Law Versus Criminal Law 3
Criminal Law 4
Defenses to Crimes 4
Civil Law 6
Offenses Related to Addictions 7
Basic Constitutional Rights 9
The Bill of Rights 9
The Legislative Branch 11
Statutes Regulating Addictions 12
Conclusion 16
References 16
2 . Addictions and the Law 1 7
Norman S. Miller and Sara Spratt
Mens Rea and Capacity 18
Definition and Relevance to Addictions 18
Legal Precedent 19
Addictive Disease 19
Intoxication and Addiction 19
Legal Precedent 20
Criminal Law 20
Insanity Defense 20
Legal Precedent 20
Criminal Competence 21
Civil Competence 21
Alcohol and Drug Use and Addiction as Risk Factors in
Crime and Criminal Intent 21
Civil Law in Selected Populations 22
Child Abuse and Custody 22
Sexual Offenders 23
Malingering 23
v
vi Contents
Corrections and Coerced Treatment 24
Goals of Treatment 24
Diversion 24
Prevalence of Alcohol and Drug Disorders during Incarceration 25
Prevalence of Suicide and Alcohol and Drug Disorders during
Incarceration 25
Legal Precedent 25
The Death Penalty and Addictions 26
Involuntary Hospitalization 2 6
Malpractice 26
Competence to Sign into an Institution 27
Informed Consent 27
Injury to a Third Party by Alcoholics and Drug Addicts 28
Adolescents and Juvenile Court and Addictions 29
Prevalence of Alcohol and Drug Use and Disorders in
Juvenile Populations 29
Legal Precedents 30
Forensic Pathology and Drug Testing 30
Forensic Pathology 30
Drug Testing 30
Medical Records 30
Rehabilitation Acts 31
Conclusion 31
References 32
3 . Physician Practice of Addictions in Medical Practice 37
Norman S. Miller
Introduction 37
Clinical Prevalence 38
Prevalence of Alcohol and Drug Dependence in the General
Population 38
Prevalence of Multiple Drug Use and Dependence in
Treatment 38
Prevalence in the Medical Population 39
Prevalence in Family and Workplace Populations 39
Clinical Diagnosis 39
Risk Assessment by Physicians 40
Physical Examination and Laboratory Testing 40
Clinical Course and Pathophysiology 4 1
Clinical Comorbidity 41
Treatment of Medical Disorders Associated with Alcohol and
Drug Use and Addiction 41
Physician Intervention 41
Requirements of Physicians for Diagnosing and Treating
Addictive Disease 42
Abstinence-Based Method 43
Improving Treatment for Alcoholism 44
Contents vii
Why Physicians are Unprepared to Treat Drug- and Alcohol-
Related Disorders 4 5
Recommendations for Improving Education Training 46
Research Studies on Medical Education in the Area of
Addictive Medicine 47
Conclusion 49
References 49
4 . Medical Licensure and Credentialing 5 5
Mark J. Greenwood and Maureen Beasley-Greenwood
Introduction 55
Peer Review 57
Immunity 57
Confidentiality 59
Physician Profile Databases 60
Medical Licensing Boards 64
Judicial Oversight 65
Federation of State Medical Boards 67
The Model Policy 67
Compulsory Reporting 67
Examination/Evaluation 68
Grounds for Action 68
Disciplinary Action against Licensees 68
Impaired Physicians 68
The Impaired Healthcare Professional 69
Identifying the Problem 69
Ethical Responsibility and Legal Risk 69
Confidentiality versus Disclosure 71
Physician Health Program (PHP) 72
References 72
5 . Privacy within the First Decade of the Twenty-First Century 7 5
Roy G. Beran
Introduction 75
Codes of Conduct for Privacy 76
Patient Access to Medical Records 7 6
Electronic Health Records 7 7
Update from the Privacy Commissioner 78
Practice Audits 79
Conclusion 79
References 80
6 . Bioethical Decisions, Substance Use and Addiction: The
Clinical Context 8 1
Sana Loue
Introduction 81
Substance Use, Addiction and Informed Consent 8 2
viii Contents
Pregnancy , Substance Use and Addiction 83
The Effects of Substance Use on the Fetus 83
Legal Responses to Maternal Substance Use during Pregnancy 85
Ethical Issues for the Healthcare Provider 86
Liver Transplantation 87
Treating Pain 89
Conclusion 92
References 92
7 . Domestic Public Health Law 9 7
Lesley Stone and Susan C. Kim
Introduction 97
Controlled Substances 98
Harrison Narcotics Act of 1914 98
Federal Bureau of Narcotics and Henry Anslinger 99
Food and Drug Administration (FDA) 102
Food, Drug and Cosmetic Act of 1938 103
Prescription Drug User Fee Act of 1992 (PDUFA) 103
Federal Agency and Policy: Supply and Demand 1 05
Reducing the Supply of Illegal Drugs in the United States 105
The Other Side of the Coin: Reducing Demand for
Drugs in the United States 107
Conclusion 110
References 110
8 . International Law, Public Health and Addiction 1 13
Peter J. Hammer
What is International Law? 114
International Law in the Field of Addiction 1 15
Addiction: The Perspective of Drug Control 115
International Organizations and the Infrastructure of Drug Control 119
Addiction: The Perspective of Public Health 121
Why is International Law Relevant to Addiction Practitioners? 1 24
Physicians and Scientists 125
Lawyers and Judges 126
Social Workers, Community Activists, Policymakers and Sufferers of
Addiction 130
Addiction and Human Rights 130
International Advocacy and the Framework Convention on Tobacco
Control 131
References 132
9 . Medical Malpractice 1 35
Mark Cooney
Overview of Medical Malpractice Law 1 35
The Essential Elements 135
The Standard of Care: Duty and Breach 135
Contents ix
Application to Addiction Cases 136
Standard of Care and Breach 136
Causation of Damages 143
Experts 146
Informed Consent 146
Defenses 149
Comparative Negligence 149
Assumption of Risk 152
Statute of Limitations 154
References 156
10 . Expert Witness in Civil and Criminal Testimony 1 59
Norman S. Miller
Expert Qualifications 159
Federal Rule of Evidence 702 159
Federal Rule of Evidence 703 160
Role of Experts 161
Duties of Experts 161
Mens Rea and Capacity 162
Expert Role in Criminal Cases 162
Medical Malpractice 163
Expert Role in Medical Malpractice Cases 163
Medical Experts 163
Admissibility of a Medical Expert 165
Damage Experts 165
Conclusion 166
References 166
11 . Forensic Considerations in Blood Alcohol Evaluation 167
Werner U. Spitz
Introduction 167
Alcoholism 167
References 174
12 . Pharmacological Drug Effects on Brain and Behavior 1 77
Richard A. Greer and Mark S. Gold
Introduction 177
Influence of Neurobiology and Neurotransmitters 178
Molecular Mechanisms and Neurobiological Consequences
of Drug and Alcohol Use 179
Performance-Enhancing Drugs 184
Conclusion 188
References 188
13 . Forensic Toxicology 1 93
Michele L. Merves, Bruce A. Goldberger
Introduction 193
Postmortem Forensic Toxicology 194