Involuntary Detention

Psychiatric Emergencies 443

(i) Give salicylate or paracetamol for mild to moderate pain, and

methadone orally or i.m. for severe pain.

(ii) Give the patient diazepam 5–10 mg orally if signs of opiate

withdrawal occur, repeated as required.

3 Refer patients wishing to stop their habit and seeking help to:
(i) Drug and Alcohol Dependency Unit.
(ii) Social work department.
(iii) Drug dependency 24-h emergency organization such as Narcotics
Anonymous.
(iv) GP.

Benzodiazepine and solvent addiction

MANAGEMENT

1 Patients who are addicted to these groups of drugs all require referral to a
specialist drug and alcohol dependency clinic to coordinate their withdrawal
regimen. Help and advice is available from:
(i) Social work department.
(ii) Drug dependency organization including self-help groups.
(iii) GP.

INVOLUNTARY DETENTION

1 It is sometimes necessary to detain a patient against his or her will in or
through the emergency department under the prevailing local Mental
Health Act (MHA).
(i) Always request the help and advice of the psychiatric team in
such circumstances. It is unusual to have to act in its absence.

2 Generic criteria that must be fulfilled for instigating involuntary detention
for assessment include:
(i) The person appears to have a mental illness that requires
immediate assessment at an authorized mental health service.
(ii) There is a risk the person may cause harm to self or another, or
might suffer serious mental or physical deterioration.
(iii) There is no less restrictive way of ensuring the patient is
assessed.

Warning: if a patient should demand a controlled drug, explain that it is

actually an offence for a doctor to administer or authorize the supply of a

drug of addiction, except in the treatment of an organic disease or injury,

unless licensed to do so.

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