Substance abuse

Substance abuse is a robust predictor of an increased probability of violence and criminality in the mentally disordered. The coexistence of substance abuse with mental disorders significantly increases the risks of violent behaviour. (.1. 75777 and 79 The association between intoxication and violent behaviour is as complex as it is clear.(80) It should also be noted that the unwanted effects of therapeutically administered agents can contribute to risk. The disinhibiting effects of benzodiazepines are well known (and possibly overemphasized); less well known is the potential for the intense restlessness and agitation of akathisia to erupt in violence. The presence of continuing substance abuse with intermittent or chronic intoxication remains one of the most potent predictors of future violence in the mentally disordered. No particular form of substance abuse has been demonstrated to be more or less predictive. Alcohol and marijuana are the most frequently abused intoxicants and will be the most commonly encountered contributors to violence in the mentally disordered.

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