The link between drug and alcohol intoxication and deaths and serious incidents in police custody

Following the Home Secretary’s announcement last year of a major review into deaths and serious incidents in police custody, a consultation entitled, Independent Review of Deaths and Serious Incidents in Police Custody, recently closed.

In the second of a series of blogs centred around our response to the consultation, we look at the link between drug and alcohol intoxication and deaths and serious incidents in police custody.

The consultation sought views across 17 key questions, including what ways could the risk of death and serious incidents in police custody be avoided, what actions could be taken by police to avoid such events following the use of force, what actions could be taken by police and other organisations to reduce the risk of self-inflicted deaths within 48 hours of police custody and, to what extent is mental health a factor in deaths and serious incidents in police custody.

The review, which is being conducted by Dame Elish Angliolini QC, will examine the procedures and processes surrounding deaths and serious incidents in police custody, including the lead up to such incidents, the immediate aftermath, through to the conclusion of official investigations.

As with issues surrounding mental health which we covered in our previous blog, in our experience of working with the families of those that have died in custody and with individuals who have experienced some form of serious incident while in custody, we have seen that that mismanagement of persons under the influence of drugs and alcohol is a common contributory factor to deaths and serious incidents.

In our response we identified issues surrounding the training and education of police officers in management of intoxicated persons in police custody, treatment of intoxicated persons not in police custody and the availability and role of drug and alcohol services in police custody.

Training and Education

Police have a duty to take reasonable steps to keep safe all persons in police custody. We have serious concerns that officers are not receiving adequate training and education in the management of people under the influence of drugs and alcohol to enable them to fulfil their duty of care in such cases.

We have observed a concerning recurrent trend of police officers failing to take seriously the health risks associated with intoxication, largely due to ignorance on the part of the officers. In our experience it is very common for police officers to take the approach of placing an intoxicated person in a cell to ‘sleep it off’ without regard to the serious risk this presents. Under Code C Annex H of the Police and Criminal Evidence Act 1984, police are required to carry out regular ‘rousability checks’ to ensure that the detained person’s physical state has not deteriorated. As part of these checks police officers must attempt to wake the detained person and to engage them in conversation to check that they are able to respond to basic questions and commands. Should they not respond appropriately then medical attention should be sought. Regrettably we have seen repeated examples of these checks not being carried out properly or as frequently as they should be, if indeed at all, which places the wellbeing of the intoxicated person at serious risk. In our view this risk can be reduced significantly by educating police officers about the health risks of severe intoxication and of how to respond accordingly, so that the detained person receives treatment similar to persons suffering from other debilitating and high-risk health conditions, rather than simply being dismissed as a ‘drunk’ or a ‘drug addict’ as we are concerned is all too often the case.

We are also concerned about police officer understanding of the risks of drug and alcohol withdrawal, which is a common contributing factor in cases of self-inflicted injuries and deaths in custody. We consider that training and education is required to teach police staff to spot the signs of detained people who are suffering from drug and alcohol withdrawal symptoms, to be alive to the risks associated with this and to ensure that appropriate monitoring and treatment is put in place.

Treatment of intoxication persons not in police custody

We have experience of cases where members of the public who have had some level of contact with the police, but are not formally in custody, have fallen seriously ill as a result of intoxication but police officers have failed to carry out ‘rousability checks’ or to ensure that medical treatment is sought as would be required were the person to be in police custody. We consider that Code C Annex H of the Police and Criminal Evidence Act 1984 should be extended to apply to all persons who have contact with police, not just those in custody. Whilst it might be argued that this measure would place a further burden on an already resource stretched police service, we would suggest that the impact of this could be reduced significantly by each constabulary establishing closer and more effective links with local ambulance services. This is a simple measure with true lifesaving potential.

Access to Drug and Alcohol Support Services

Drug and alcohol intoxication and withdrawal are major contributing factors to deaths and serious incidents in custody. Sadly, our experience is that drug and alcohol support in police custody is poor and does not often address the needs of the detained person. Our concern is not only that police officers are inadequately trained in managing such people, but that police station medical staff are also not sufficiently experienced or qualified in offering support which results in inadequate treatment. We consider that the situation could be improved significantly by ensuring better interaction between the police and local drug and alcohol support services and by compelling police stations, or borough areas, to at all times have at least one drug and alcohol support nurse available to provide support to police in the management of persons suffering from intoxication or withdrawal.

Drug and alcohol dependency and withdrawal is also a major cause of serious injury and death post-custody, particularly in cases of suicide and self-harm where the mental health of the person in question has been adversely affected by their arrest or time in custody. Sadly, our experience is that the vulnerability of such individuals is being ignored by the police and that the pre-release risk assessment process is inadequate in identifying and addressing such risks. To address this, we suggest that where a person has been identified as withdrawing from drugs or alcohol whilst in police custody, a drug and alcohol support professional should be involved in the pre-release risk assessment and be available to speak with the detained person prior to their release. Furthermore, we suggest that where the person is identified as being at risk, there should be an automatic referral to community drug and alcohol support services to ensure that the drug and alcohol support continues following release, when the person is likely to be at their most vulnerable.

In Part 3 of our series of blogs, we will examine the role of the police after someone has died in their custody.

Cormac McDonough is a solicitor in the civil liberties team at Hodge Jones & Allen.