Alcohol and substance misuse expert witness in Scotland
Instructions in this field ask a narrower and more technical question than a general psychiatric report: is there dependency on alcohol or drugs, on what evidence, and what does that mean for the legal question in issue. He holds an MSc in alcohol and drug addiction and is dually accredited in addiction psychiatry, and he brings that specialist training to bear on diagnosis, relapse risk and treatment planning rather than a general adult opinion.
He acts in personal injury actions where alcohol or drug use is said to pre-date or follow an accident, in employment and occupational health matters where fitness for safety-critical work is in question, in fitness to practise proceedings, in family actions, and in cases concerning drug-related deaths and alcohol-related brain damage. Instructions come from pursuer and defender agents, employers, regulators and, on a precognition basis, from the Crown and defence in criminal proceedings.
What Dr Qureshi can advise on
- Whether the person meets diagnostic criteria for dependence syndrome or harmful use under ICD-11, and the severity of that dependence.
- The reliability of self-reported consumption against collateral evidence — GP records, blood markers, liver function tests and, where available, hair or PEth testing.
- The relationship between substance use and a claimed psychiatric or physical injury, including which came first and which is driving the other.
- Relapse risk, the factors that increase or reduce it, and the reasoning behind any percentage or category of risk given.
- Capacity to return to or continue in safety-critical or regulated work, including driving, and what monitoring or conditions would reduce risk to an acceptable level.
- Evidence of alcohol-related brain damage, including the pattern of cognitive deficit and whether formal neuropsychological testing is indicated.
- In drug-related death cases, the deceased's pattern of dependence, engagement with treatment services, and missed opportunities for intervention where records permit that opinion.
- The treatment reasonably required — detoxification, rehabilitation, community support — its likely duration and the evidence base for it.
Where a case turns on toxicology interpretation beyond his competence, or on neuropsychological testing proper, he says so and recommends the appropriate additional expert rather than extend his opinion past the evidence.
Typical instructions
- Fitness to return to safety-critical work
- An employee with a documented history of alcohol dependence seeks to return to a driving or machinery-operating role after treatment. The employer needs an opinion on current abstinence, relapse risk, and what monitoring — for example regular blood testing — would make return safe.
- Personal injury with alleged pre-existing dependency
- A defender agent instructs a report to test whether a pursuer's ongoing symptoms are attributable to the index accident or to an alcohol use disorder that predates it, drawing on GP records going back over a decade.
- Alcohol-related brain damage in a capacity dispute
- A family action or welfare guardianship application where sustained heavy drinking raises the possibility of cognitive impairment. The instruction asks whether the presentation is consistent with alcohol-related brain damage and whether further neuropsychological assessment is required.
- Precognition in a drug-related death investigation
- Solicitors acting for a family or for a treatment provider following a drug-related death request a report addressing the deceased's known pattern of dependence and engagement with services, based on records rather than examination.
What the report includes
The report sets out the instructions received, the documents considered, a detailed substance use history taken from the examinee and cross-checked against records, mental state examination, and a reasoned opinion addressing each question in the letter of instruction. Diagnostic conclusions are referenced to ICD-11 criteria and the specific evidence supporting each criterion is identified rather than asserted.
Where self-report and collateral evidence conflict — a common feature of these instructions — the conflict is stated openly, and the opinion explains which evidence is preferred and why, including what weight is placed on biochemical markers where available.
The report closes with a statement of truth and a declaration that the duty to the court or tribunal overrides any duty to the instructing party, in accordance with the Royal College of Psychiatrists' guidance on expert evidence and the relevant procedural rules.
Related expertise
- Personal injury — Psychiatric injury reports for pursuers and defenders in Scottish personal injury actions.
- Fitness to practise — Health assessments and reports for regulatory bodies including the GMC.
- Employment and occupational health — Work-related stress, ill-health retirement and employment tribunal psychiatric evidence.