Regional differences in outcome from subarachnoid haemorrhage: comparative audit.

We found that 16% of all violent crimes in Sweden during 1988-2000 were committed by people who had hospital discharge diagnoses of alcohol misuse, and more than a tenth of all violent crimes were committed by patients diagnosed as having misused drugs. Treatment services aimed at alcohol and drug misusers can potentially reduce violent offending. The approach of population attributable risk is one way of exploring the relationship between substance misuse and violent crime. It assumes a causal relationship between the two and so estimates the maximum possible impact that any intervention might have. However, the co-occurrence of substance misuse and violent crime does not necessarily imply a simple causal relationship. Integrating mental health and substance misuse services leads to improved outcomes. This integration should be extended to the criminal justice system. The costs to the criminal justice system of drug related crime are enormous—for example, in the United Kingdom, a conservative estimate is £1bn ($1.8bn; €1.5bn) annually. Interventions to reduce the risk of violence in patients who misuse alcohol and drugs could be highly cost effective.