Abstract
In recent years there has been increasing interest in the link between mental disorder, violent behaviour/offending and substance misuse. However, because of the low prevalence of serious offending, most studies to date have concentrated on relatively minor offending. The aims of our study were twofold. We wanted to investigate the frequency and pattern of substance use by mentally disordered offenders committing serious offences, both at the time of the offence and in the year prior to detention. We also wanted to determine whether the prevalence of substance use had increased over time. Data on patients admitted to the Special Hospitals from 1972 to 1998 were collected from the Special Hospital Case Register. Overall, 18.6% of patients had taken substances at the time of the offence and 38.3% admitted to regular substance use in the 12 months prior to detention. However, from the early 1970s to the late 1990s the percentage of patients using substances at the time of the offence and admitting to regular substance use in the 12 months prior to detention, had risen almost threefold. The rising prevalence of substance use in this population highlights, yet again, the necessity for drug and alcohol treatment programs in secure settings.