Editor,—Carrigan et al through the use of toxicological screening suggests a significant prevalence of drug and alcohol use in the British accident and emergency (A&E) trauma population.¹ Our own audit of 351 patients attending St Thomas's Hospital A&E in London, examined the part alcohol plays in the use of radiological investigation for traumatic injuries, found a similar prevalence. However, a simple questionnaire type assessment carried out by the A&E doctor seems to be as effective at indicating alcohol intoxication as blood alcohol concentrations, thus avoiding any ethical and financial issues in obtaining blood specimens. Validation for such screening assessments already exists^{2, 3} and as such we advocate the routine use of …