Substance use in the general hospital

Addict Behav. 2003 Apr;28(3):483-99. doi: 10.1016/s0306-4603(01)00263-5.


Introduction: People misusing substances are overrepresented in health settings. Substance misuse can also be an underlying factor complicating medical diagnosis and management.

Aims: (i) To establish the prevalence of substance misuse in the general hospital inpatient population; and (ii) to examine the relationship between medical diagnosis and substance misuse problem as identified by screening tools.

Method: This study adopted a three-step screening approach including a prospective questionnaire survey, interview, and case note review. Subjects included all adult patients admitted to a London teaching hospital over a 1-week period.

Results: Seventy percent completed the questionnaire. Twenty-three percent was currently smoking, 14% was rated positive for alcohol misuse, and 12% positive for drug misuse. Only 65% of patients was screened for smoking, 54% for alcohol, and 9% for other substances.

Conclusions: People misusing one substance were more likely to be misusing others, hence the importance of screening all patients for all substances. Doctors were screening a small percentage of patients and they identified and intervened with only the severe ones.

MeSH terms

  • Adult
  • Aged
  • Alcoholism / epidemiology
  • Analysis of Variance
  • Female
  • Hospitals, General / statistics & numerical data
  • Humans
  • Inpatients / statistics & numerical data*
  • Interview, Psychological / methods
  • London / epidemiology
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Prevalence
  • Regression Analysis
  • Substance-Related Disorders / epidemiology*
  • Surveys and Questionnaires
  • Tobacco Use Disorder / epidemiology