Routine screening for syphilis is justified in patients admitted to psychiatric, alcohol, and drug rehabilitation wards of the Veterans Administration Medical Center.

Of 1515 patients admitted to psychiatric, alcohol, and drug rehabilitation services in the Veterans Administration Medical Center, Buffalo, NY, during the year 1987, who were screened by serologic tests for syphilis, 16 (1.05%) had positive rapid plasma reagin and fluorescent treponemal antibody-absorption tests for syphilis. A positive serologic test result was not suspected on clinical grounds in any of these patients. All were detected by routine screening. Of the 16 patients, 15 had charts available for review. Seven patients were treated for primary or late syphilis; four patients had received previous treatment; and four patients had no evaluation of test results and received no treatment. Routine screening of hospitalized patients who are alcohol or drug abusers is justified, but close follow-up is necessary to make screening meaningful.