Substance misuse in acute general medical admissions

We conducted a prevalence study of current substance misuse amongst acute general medical admissions, and compared the sociodemographic profile of this group of patients with total admissions and the local catchment population. Patients were included in the study if they were resident in the Lambeth, Southwark and Lewisham (LSL) Health Commission catchment area and were aged between 18 and 85 years. The prevalence of non-dependent misuse was of particular interest. Of 2988 acute admissions, 609 (20%) were identified as misusing alcohol and/or drugs, 277 (9%) being identified by the admitting doctor and 332 (11%) being identified by means of a Health and Lifestyle Questionnaire (HLQ) which included the Alcohol Use Disorders Identification Test (AUDIT). The majority 437 (72%) of the identified patients had an alcohol problem. A smaller proportion, 116 (19%) were currently using illegal drugs and 56 (9%) were polydrug users. Compared with patients who misused either drugs or alcohol, alcohol misusers were more likely to be older and Irish, whereas users of illegal drugs were more likely to be younger and Black. Significantly more 'at risk' drinkers were identified by the AUDIT questionnaire than by the admitting doctor. This study supports the policy of routine screening for health-damaging behaviours and the implementation of health promotion strategies in general hospitals.