title: Substance use among medical students: time to reignite the debate?
abstract: BACKGROUND
  Substance use among medical students could impact on the conduct, safety and efficiency of future doctors. Despite serious medicolegal, ethical and political ramifications, there is little research on the subject, especially from the Indian subcontinent. We aimed to explore the patterns of substance use among a sample of medical students from the Indian subcontinent.
  
  
  METHODS
  An opportunistic, cross-sectional survey of medical students from 76 medical schools attending an inter-medical school festival. A brief self-reported questionnaire was used to identify current and lifetime use of tobacco, alcohol, cannabis, heroin and non-prescription drugs. Multivariable logistic regression analysis was used to identify factors associated with illicit substance use.
  
  
  RESULTS
  Responses from 2135 medical students were analysed. Current alcohol and tobacco (chewable or smoked) use was reported by 7.1% and 6.1% of the respondents, respectively. Lifetime use of illicit substances was reported by 143 (6.7%) respondents. Use of illicit substances was strongly associated with use of tobacco, alcohol and non-prescription drugs.
  
  
  CONCLUSIONS
  This study provides a snapshot of the problem of substance use among medical students from the Indian subcontinent. The reported prevalence of alcohol and illicit substance use in our sample was lower, while tobacco use was similar, when compared with data from western studies. Further research is needed from the Indian subcontinent to study nationwide patterns of substance use among medical students, and to identify important determinants and reinforce protective factors. Strategies need to be developed for supporting students with a substance use problem.
authors.affiliation: Academic Unit of Psychiatry, University of Bristol, Bristol, UK. dheeraj.rai@awp.nhs.uk
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Rai
authors.forename: Jorge
authors.initials: J
authors.lastname: Gaete
authors.forename: Saket
authors.initials: S
authors.lastname: Girotra
authors.forename: Hem Raj
authors.initials: HR
authors.lastname: Pal
authors.forename: Ricardo
authors.initials: R
authors.lastname: Araya
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D010815:Physician Impairment / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D013337:Students, Medical / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology*