Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

16. Addiction and the Law 359“Blackouts” are real phenomena that can occur in the occasional user, aswell as in the chronic abuser or the alcohol-dependent person. They can leadto a person being unable to account for hours or days of his or her life. Duringa blackout, the individual may not be perceived by observers to have anyimpairment of cognitive or intellectual ability. This does not mean that committedacts were not intended. State-dependent memory may also occur, withreturn of some learning during intoxication. In some cases in which criminalor civil offenses have been alleged, the defendant who is an abuser of drugs oralcohol may state that he or she is not able to comment upon the act becausehe or she was in a state of “blackout.” The actor’s apparent lack of impairmentduring the actions leads to very different accounts of the action.ADDICTION AND CIVIL MATTERSCivil matters are often encumbered by addictions. The topics of civil law rangefrom family matters (e.g., divorce, custody) to administrative proceedings (e.g.,medical or pilot’s license proceedings), to personal injury, to negligence to willsand estates. As in criminal proceedings, the psychiatrist may be asked to placethe substance use in the context of the past behavior or to make predictionsabout future behavior. We discuss a number of frequently visited topics. Issuesrelating to the workplace and the Americans with Disabilities Act (ADA) arediscussed in Chapter 15, this volume.Family and Matrimonial LawIn disputes over divorce, custody, guardianship, adoption, or child safety, thesubstance use of any involved party is commonly at issue. The expert is oftenasked to comment upon the substance use of parents and effects on the child,with recommendations for custody, visitation, and treatment as a pretense forrights. The presence of an SUD does not mean lack of fitness, but it can be afactor. The fiercely adversarial nature of these proceedings often impedes theformation of a valid picture.Personal InjuryWhen an individual who is injured sues another party for damages, the defendantmight allege that the plaintiff was intoxicated at the time. Either sidemight need an addiction psychiatrist to assist or rebuff the claim of intoxicationand long-term addiction. Injured parties may also blame the party that providesthe substance of abuse. Many cases have exposed the liability of bars, bartenders,and parents of minors (Wagenaar, 2001).