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Jason Payne-James and Deborah Rogers (July 2002 JRSM1) draw wider attention to a report2 identifying that many complainants of sexual assault have high concentrations of alcohol in their blood. In a Home Office report it was recommended that, when psychoactive drugs are involved, a clinical psychologist should testify as to the effects of the drug and that a toxicologist would be able to give evidence as to the complainant's behaviour against that of typical reactions to the drugs in question3. In the UK clinical psychologists are not necessarily trained in substance misuse and may never have seen an acutely intoxicated patient in a forensic setting as part of their practice. Thus clinical psychologists who are not specialists in addiction may not be able to advise investigators or provide evidence in court on the effects of drugs. Most toxicologists, except for a few who are medically qualified, cannot comment expertly on the clinical effects of drugs on an individual, although they may give helpful general advice on the effects of drug metabolites and level of toxicity.
In many cases the forensic physician who has attended the complainant shortly after the incident and who has taken a detailed history and performed a full examination will be the person in the best position to assist the court with an informed opinion, based on the objective results of an appropriate clinical examination, as to whether or not the complainant is intoxicated at the time of presentation. Furthermore his/her clinical findings will inform the analytical toxicologist's approach to the samples submitted to the laboratory. The opinion of a competent forensic physician as to which substances may have caused the signs exhibited and symptoms described by the complainant may be invaluable to the investigators and to the court, before the laboratory results have become available or in those cases where the complainant has presented too late for useful toxicological results to be obtained.