A series of 109 adult orthopaedic inpatients was interviewed about alcohol and other drug use and alcohol-related problems in general in the week preceding admission to hospital. The most frequently used drugs were alcohol (reported by 75%), tobacco (53%), analgesics (28%) and cannabis (15%). Alcohol was used hazardously by 28% of patients. More patients scored as problem drinkers on the Trauma Scale (52%) than the Brief MAST (7%). The detection of alcohol-related problems at an early stage is important. It is suggested that trauma victims in hospital be routinely screened for this.