title: Problematic recreational drug use: is there a role for outpatient sexual health clinics in identifying those not already engaged with treatment services?
abstract: Background There is an association between recreational drug use, high-risk sexual activity and sexually transmissible infections. Studies have shown a higher prevalence of drug use in those accessing sexual health services; however, there are minimal data on the proportion with problematic recreational drug use. We aimed to understand whether sexual health clinics could identify problematic drug and alcohol use as a novel referral pathway into treatment services.
  
  
  METHODS
  Males attending two sexual health clinics in London completed questionnaires. Data were collected on demographics; gender of sexual partner; use of alcohol and recreational drugs; if they felt they had problematic use of drugs, alcohol or both; and if they had sought help for their problematic use.
  
  
  RESULTS
  In total, 867 males completed the questionnaire; 387 (44.7%) were men who have sex with men (MSM). MSM had significantly higher lifetime use of any drug compared with non-MSM (80.6% vs. 62.5%; P<0.0001). Thirty-five (4.7%) self-identified problematic drug or alcohol use, with no difference between MSM and non-MSM (6.3% vs. 3.5%; P=0.08). Of those with problematic drug or alcohol use, 20 were currently or had been engaged with a treatment service and 15 had never engaged with treatment services. MSM were more likely to have ever sought help for drug or alcohol problems compared with non-MSM (P=0.003).
  
  
  CONCLUSIONS
  Some individuals attending sexual health clinics with problematic drug use have not engaged with treatment services. It is therefore appropriate to develop screening tools for sexual health clinics to identify these individuals and novel referral pathways to engage them in treatment services.
authors.affiliation: Clinical Toxicology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust and King's Health Partners, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: Caitlyn
authors.initials: C
authors.lastname: Lovett
authors.affiliation: Clinical Toxicology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust and King's Health Partners, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Emergency Medicine, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Hunter
authors.affiliation: Genitourinary Medicine, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: John
authors.initials: J
authors.lastname: White
authors.affiliation: Clinical Toxicology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust and King's Health Partners, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: Paul I
authors.initials: PI
authors.lastname: Dargan
authors.affiliation: Clinical Toxicology, Guy's and St Thomas' National Health Service (NHS) Foundation Trust and King's Health Partners, Westminster Bridge Road, London, SE1 7EH, UK.
authors.forename: David M
authors.initials: DM
authors.lastname: Wood