Substance Misuse and Fitness for Interview

A substance misuser may be rendered unfit for interview by virtue of either intoxication or withdrawal. Generally speaking, intoxication is easy to recognize, and the police will usually wait until the intoxication has cleared before starting their questioning. However, problems may be encountered with hallucinogenic substances. For example, the mental state may fluctuate in the recovery stages of an LSD experience, which may not be immediately obvious to the interrogator (73).

Withdrawal states can pose a bigger problem for the doctor assessing fitness for interview. Although most confessions made in these circumstances are reliable (74), it should be recognized that the person suffering from drug withdrawal may be particularly vulnerable to providing a false confession. Such persons may believe that compliance will result in early release and that the risks entailed in providing a false confession may seem worthwhile in the presence of an overwhelming desire to re-establish access to their supply of drugs (75).

Although symptoms of mild withdrawal from opiates, for example, is considered unlikely to be a barrier to interview (62,73), the physical and mental distress occasioned by established withdrawal may seriously impair a suspect's fitness to undergo the somewhat threatening and difficult experience of police interrogation.

When faced with a suspect suffering from severe withdrawal, the doctor should consider advising that the interview be deferred until such time as the withdrawal has subsided or been adequately treated. If the doctor decides to treat the withdrawal state, consideration should be given to the risk that the therapeutic intervention, which may in itself have a bearing on fitness to interview. Arranging for therapy that the suspect has been receiving in the community to be continued in police custody is unlikely to influence fitness for interview (76,77). However, when substitution therapy is initiated in custody or when symptomatic treatment alone is provided, the doctor may well need to assess the effect of the treatment before an interview occurs.

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