A history of drug and alcohol use influences various aspects of inpatient care. It is important to ascertain the history of drug and alcohol use in new admissions. This knowledge ensures the appropriate detoxification of patients. It also allows the management of various risks such as the risk of violence, of escape, of drugs being brought onto the ward and of drug use amongst other patients. It can explain the lack of therapeutic progress in patients.

To ascertain whether new patients admitted to an acute ward on a medium secure unit in London are being asked about their drug and alcohol usage history.

To establish what proportion of 18 male inpatients on a medium secure unit have their drug and alcohol history documented in their admission notes.

The notes of all 18 patients on an acute ward in a medium secure unit were scrutinised. An audit tool was used to record whether the admission notes contained an entry about the history of drug and alcohol use.

There were 18 male patients. Four were under a section 3, four under a section 47, four under a section 48, one under a section 38, five under a section 37 of the Mental Health Act 1983. Only 5 of 18 patients had been asked about their history of drug and alcohol use on admission.

An important part of the history is being missed in a large proportion of new male admissions to a medium secure unit.