Drugs and Child Maltreatment

1. Front Matter

   Pages i-vii

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2. The Child Harmed by Drugs

   • David A. Joyce, Peter M. Winterton

   Pages 1-5

3. Identifying the Drug

   • David A. Joyce, Peter M. Winterton

   Pages 7-11

4. The Clinical Presentations

   • David A. Joyce, Peter M. Winterton

   Pages 13-41

5. Laboratory Investigation of Drug Exposure

   • David A. Joyce, Peter M. Winterton

   Pages 43-61

6. Social and Family Context and Its Relevance to Child Maltreatment Through Drugs

   • David A. Joyce, Peter M. Winterton

   Pages 63-89

7. Protecting the Child After a Diagnosis of Maltreatment Through Drugs

   • David A. Joyce, Peter M. Winterton

   Pages 91-107

8. Writing a Medico-Legal Report in a Case of Child Maltreatment with Drugs

   • David A. Joyce, Peter M. Winterton

   Pages 109-113

9. Conclusions

   • David A. Joyce, Peter M. Winterton

   Pages 115-116

This book combines experience in child protection with expertise in clinical pharmacology and forensic toxicology, to set out a broad contemporary understanding of child maltreatment with drugs. It explores presentations that range through ante-natal exposure, factitious illness, deliberate poisoning, drug accidents while in the care of drug-affected adults, misuse of therapeutic drugs and the drug-related death of a child. It describes how to recognise where deliberate drug exposure or perversion of proper therapeutics is being used to harm a child, how to use laboratory testing to confirm a diagnosis, how to combine medical and social care with the need to gather legal evidence and how to deploy social, medical and legal resources for child protection. The roles of the forensic toxicologist and contemporary forensic laboratory methods in resolving cryptic presentations are discussed in each context. There is guidance on effective communication about drugs within the child protectionteam and on writing reports for legal purposes, on the way to returning the child to safety. The book also explores the particular difficulties that arise in reconciling parents' rights and cultural beliefs with the obligation to document a child’s drug exposure and in dealing with parents and carers who themselves may be drug-impaired.

• Child Maltreatment and Drug Abuse
• Managing Child Maltreatment
• Children and Confusing Medical Conditions
• Combining Medical Care
• Deploy Resources for Child Protection
• Recognizing Maltreated Children
• Childhood Drug Poisoning
• Family Context and Child Maltreatment
• Social Context and Child Maltreatment
• Diagnosis of Child Maltreatment through Drugs
• Laboratory Testing for Drug Exposure

• Medicine and Pharmacology, University of Western Australia, Crawley, Australia

  David A. Joyce

• Child Protection Physician, Perth Children’s Hospital, Nedlands, Australia

  Peter M. Winterton

David Joyce is a physician practicing in clinical pharmacology and forensic toxicology. He is professor of medicine and pharmacology at the University of Western Australia, director of drug analysis services at PathWest Laboratory Medicine in Perth, Western Australia and head of clinical pharmacology at Sir Charles Gairdner Hospital, also in Perth. His consultative practice includes forensic toxicology in medical, coronial and child protection contexts. 


Peter Winterton is a child protection and family physician with forty years of experience over a wide area of clinical and medico-legal  medicine. He has been involved in child protection work since the late 1970s when the recognition of child sexual abuse medicine became a recognized sub-speciality. From 1999-2013 he was Medical Director of the Child Protection Unit at the Perth Children’s Hospital. Especially during this period  he became increasingly aware of the interaction of drugs and child maltreatment. He has worked collaboratively with the other  author of this book on many cases, being the inspiration for putting this work together.  His unique combination of child protection medicine and family medicine has allowed him to appreciate the harm of  drug misuse across the whole community and its potential inter- generational  effects at every level of society, from prenatal exposure to adulthood. 

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