Comorbidity between a substance use disorder (SUD) and another psychiatric disorder is known as dual diagnosis. The relevance of SUD with mental illness owe to his influence in the clinical practice, evolution and costs of care.

At the Hospital of Zamudio, the determination of substances of abuse in urine begins in January 1999 and in May 2003 a practical guide to detection and norms substance use was established and revised in late 2006.

The objective of this work is to make a valuation in this issue, reflected in the petitions made during this time and the evolution of the determinations of drug misuse, both of them indicating the understanding of the importance of dual diagnosis

Determinations of toxics in urine are collected from January 1999 to December 2009.

:

• YEAR NUMBER OF TOXIC DETERMINATIONS

• 1999 2644

• 2000 2411

• 2001 3360

• 2002 6456

• 2003 10199

• 2004 9175

• 2005 8724

• 2006 8689

• 2007 8362

• 2008 10766

• 2009 14625

The distribution of toxic determinations is mainly between amphetamines, opiates, THC and cocaine, in equal proportion (25% for each approximately).

The gradual increase over the years, could be translated into a greater awareness of the importance of dual diagnosis.

However, the homogeneous distribution of the petitions among the different toxics perhaps could lead to the need of an implementation of the protocol, considering that sometimes the physicians order the screening without taking into account the economical and technical difficulties of the laboratory and the previous history of inpatients.