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Am Fam Physician. 2023;108(3):295-300

Author disclosure: No relevant financial relationships.

Case Scenario

D.H., a 24-year-old patient with opioid use disorder, presents to my clinic for care following minor injuries sustained during an altercation with the police. D.H. spent the weekend in a detention center before being able to post bail. During initial screening for mental health and substance use, D.H. reports symptoms of hypervigilance and increased opioid cravings. What specific clinical or medicolegal issues should I, as the treating family physician, consider or be aware of to optimize the quality of care provided to this patient?


Justice system involvement is defined as regular interactions with legal, law enforcement, and carceral systems, including detention, incarceration, or community supervision1; Table 1 outlines common justice system involvement definitions.2 In 2020, the Bureau of Justice Statistics stated that around 21% of U.S. residents (nearly 54 million people) 16 years or older had some type of contact with the police.3 More than 50% of those contacts (more than 25 million) were initiated by the police (i.e., traffic stops, arrests).3 Although the number has been decreasing in the past few years, in 2020 an estimated 5.5 million people were under correctional system control, which includes incarceration and community supervision.3

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Case scenarios are written to express typical situations that family physicians may encounter; authors remain anonymous. Send scenarios to Materials are edited to retain confidentiality.

This series is coordinated by Caroline Wellbery, MD, associate deputy editor.

A collection of Curbside Consultation published in AFP is available at

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