AbstractObjectiveTo measure the prevalence of alcohol and/or other drug (AOD) detections in suspected major trauma patients with non‐transport injuries who presented to an adult major trauma centre.MethodsThis registry‐based cohort study examined the prevalence of AOD detections in patients aged ≥18 years who: (i) sustained non‐transport injuries; and (ii) met predefined trauma call‐out criteria and were therefore managed by an interdisciplinary trauma team between 1 July 2021 and 31 December 2022. Prevalence was measured using routine in‐hospital blood alcohol and urine drug screens.ResultsA total of 1469 cases met the inclusion criteria. Of cases with a valid blood test (n = 1248, 85.0%), alcohol was detected in 313 (25.1%) patients. Of the 733 (49.9%) cases with urine drug screen results, cannabinoids were most commonly detected (n = 103, 14.1%), followed by benzodiazepines (n = 98, 13.4%), amphetamine‐type substances (n = 80, 10.9%), opioids (n = 28, 3.8%) and cocaine (n = 17, 2.3%). Alcohol and/or at least one other drug was detected in 37.4% (n = 472) of cases with either a blood alcohol or urine drug test completed (n = 1263, 86.0%). Multiple substances were detected in 16.6% (n = 119) of cases with both blood alcohol and urine drug screens (n = 718, 48.9%). Detections were prevalent in cases of interpersonal violence (n = 123/179, 68.7%) and intentional self‐harm (n = 50/106, 47.2%), and in those occurring on Friday and Saturday nights (n = 118/191, 61.8%).ConclusionAOD detections were common in trauma patients with non‐transport injury causes. Population‐level surveillance is needed to inform prevention strategies that address AOD use as a significant risk factor for serious injury.