Gendel Michael H
University of Colorado Health Sciences Center, 3300 East First Avenue, Suite 590, Denver, CO 80206, USA.
Psychiatr Clin North Am. 2006 Sep;29(3):649-73. doi: 10.1016/j.psc.2006.04.010.
There is a broad range of substance-related problems that arise for the forensic psychiatrist. For many, what is most challenging about addressing these issues are the complex behavioral, biological, clinical, and social phenomena involved. Substance- related illnesses are on the cutting edge of brain research. Substance-related behavior that brings individuals to the attention of forensic psychiatrists involves a wide spectrum of substance use patterns, but even substance misuse may have profound and relevant effects, forensically. The social forces that mold our laws and attitudes toward addictive drug use are at work in almost every forensic context. Substance-related issues provide a rich medium for the application of forensic psychiatric principles and practice. As in all of forensic psychiatric work, the psychiatrist should be familiar with each forensic context in which addiction issues arise. They should become familiar with the relevant definitions, criteria, and legal requirements that apply in each specific area of their practice, rather than assume that clinical definitions and clinical reasoning will carry them. Comfort and effectiveness with addiction issues requires willingness to continually educate oneself about this rapidly changing field, and familiarity with one's own attitudes and beliefs regarding addictive illness.
法医精神病学家面临着一系列与物质相关的问题。对许多人来说，处理这些问题最具挑战性的是其中涉及的复杂行为、生物、临床和社会现象。与物质相关的疾病处于脑研究的前沿。导致个人引起法医精神病学家注意的与物质相关行为涉及广泛的物质使用模式，但即使是物质滥用在法医方面也可能产生深远且相关的影响。塑造我们对成瘾性药物使用的法律和态度的社会力量几乎在每一个法医情境中都在起作用。与物质相关的问题为法医精神病学原理和实践的应用提供了丰富的媒介。与所有法医精神病学工作一样，精神病学家应该熟悉成瘾问题出现的每一个法医情境。他们应该熟悉适用于其执业每个特定领域的相关定义、标准和法律要求，而不是假定临床定义和临床推理就能应对。要在成瘾问题上得心应手并有效处理，就需要愿意不断自我学习这个快速变化的领域，并熟悉自己对成瘾性疾病的态度和信念。
