An audit of violent incidents in a drug treatment centre.

The aim of this study was to examine the prevalence of, and factors associated with violence in a drug treatment centre. This study is a retrospective audit of all incident forms completed at an urban drug treatment centre between December 1991 and July 1996 with reference to case notes for additional clinical information on individuals involved in violent incidents. Participants included all patients attending the centre in the aforementioned time period who were involved in violent incidents. Information was obtained about the prevalence and severity of violent incidents and patient details including main drug of abuse, route of use, reason for attendance, comorbid axis 1 diagnosis, history of previous incidents and HIV status at the time of the incident. One per cent of all patients were involved in violent incidents. Less than one quarter of incidents involved serious injury or assault. Most perpetrators were male intravenous heroin users on a methadone maintenance programme. Nurses and doctors were most frequently the victims of incidents. Ten per cent of patients had a history of previous incidents and almost half the perpetrators were HIV positive. A comorbid axis 1 diagnosis was found in 9% of perpetrators (n = 6), mainly alcohol dependence syndrome. Those on methadone maintenance programmes were most likely to be violent. Almost half the perpetrators involved in violent incidents were HIV positive. Acute psychiatric problems did not account for violence in this setting. The presence of on site security staff probably accounted for the low levels of violence when compared to general psychiatric settings