從毒癮犯罪者在精神醫學之本質談其犯罪預防之保安處分運用

毒癮犯罪者，指精神疾病犯罪者之類型為毒癮者合併其他犯罪行為時的情形。因為毒品的特性，使得毒癮者施用毒品後，在毒品之影響下，很有可能產生精神障礙並持續一段時間，而在責任能力減損的狀態下，另外導致其他的犯罪行為發生。針對毒癮者涉及殺人、傷害、搶奪或竊盜等犯罪時，關於責任能力的認定、如何有效治療其因施用毒品所造成的精神問題，及採取妥適之再犯預防處遇，已成為近年社會關注的議題，也是刑事政策上必須儘速投注更多策略、跨領域的整合研究及資源因應處理的重點。然而因毒癮者，屬於精神科診斷之「物質使用障礙症」，毒癮犯罪者兼具病人與犯人的身分，使得施用毒品者在醫療院所與司法單位間反覆進出，實務上向來難以處遇。而在毒癮犯罪者之處遇與再犯預防上，與精神醫學密不可分，在目前國內相關研究尚屬不足的情況下，本文基於此一問題意識，藉由2018年間發生一件毒癮者殺人的案件作為引子，從醫療觀點出發，就此項議題進行探討，並聚焦於現行法規中，與毒癮者相關的保安處分部分，提出對於這類患者最適合之處遇建議。

Offenders with drug addiction, referred to as drug-addicted offenders, are individuals who commit crimes while suffering from substance abuse disorders. Due to the nature of drugs, drug addicts are likely to experience mental disorders under the influence of drugs, which may impair their capacity for a certain period. This diminished capacity can lead to the occurrence of other criminal behaviors. Issues related to the determination of legal responsibility, effective treatment for the mental problems caused by drug abuse, and appropriate measures for preventing recidivism among drug-addicted offenders have become significant concerns in recent years. They require urgent attention and integration of interdisciplinary research and resources in criminal policy. However, because drug-addicted offenders fall under the psychiatric diagnosis of“substance use disorder,”they have both patient and offender identities. This dual identity complicates their treatment as they often move back and forth between medical institutions and judicial units, making it challenging to manage them effectively. Treatment and recidivism prevention for drug-addicted offenders are closely related to psychiatric medicine. Given the insufficient research in this area domestically, this paper addresses this issue by examining a case of drug-addicted offender murder that occurred in 2018. From a medical perspective, the paper explores this issue and focuses on the security disposition related to drug-addicted offenders in existing regulations, proposing the most suitable treatment recommendations for this population.