Abstract
Prevalence of substance use and patterns of choice of specific substances were investigated in a sample of schizophrenic patients detained under the Mental Health Act 1983 and residing in conditions of medium security in the independent health care sector. Patient characteristics (age and legal status) differentiating substance-using patients from non-users were explored as was the relevance of substance use to the assessment of dangerousness. The results confirm the high co-morbidity of substance use and schizophrenia with respect to detained and forensic patients. Cannabis and alcohol were most frequently used; indeed, a high proportion of patients presented a history of using only alcohol or cannabis, either in isolation or in combination. Stimulant use was prominent whereas opiate use was rare. The majority of substance-using patients were poly-substance users. Substance-using patients were younger and more frequently had a forensic history. Substance use was found to be a significant issue in risk assessment.