Violence and aggression in the Drug Treatment Centre Board

We sought to determine the prevalence of and the factors associated with violent and aggressive incidents among clients attending an out-patient methadone stabilisation and detoxification programme in Dublin.

We retrospectively examined all incident report forms over a two-year period. We also obtained information on demographics, main drug of abuse, timing and location of the incident as well as psychiatric and physical comorbidity among the perpetrators from case note review.

Two hundred and ninety-five incidents occurred over the study period. The overall rate of violence and aggression was 85 per 1,000 clients attending the centre per year. Most incidents involved verbal abuse. Females were significantly more likely to be involved in assaults compared to males. A high proportion of clients (80%) who were physically aggressive tested positive for benzodiazepine medication.

Levels of recorded violence have remained stable however racial abuse has increased in recent years. The relatively low overall rate of violence suggests that existing measures have helped reduce the number of aggressive and violent incidents in the centre. Most of the victims were either doctors, nursing staff or general assistants. This finding reflected their respective roles in the centre, which included limit setting and dealing with positive drug screens among clients.