Substance Use Among College Students in India: Necessity for Intervention

Background 
There is need to understand magnitude and pattern of substance use among youth in the community. This study was conducted with the objective to assess the pattern of substance use among college students in India. 
Methods
Ten cities were included and a medical college from each city were involved in data collection from 100 college students studying in first and final year from 2 colleges each including 1 professional college. Information was collected using a bilingual questionnaire after taking written informed consent. Institute Ethics clearance was taken from all the participating institutions. 
Results
Sample comprised of 2533 college students, 53% male, 47% female with a mean age of 20.6±2.1 years. Of the sample, 39.5% reported that they had ever used any substance and 18.1% had used tobacco, 23.4% alcohol, 6.3% marijuana/hashish, 4.8% bhang in last one year. 11.3% college students had ever taken 5 or more drinks in a day (binge drinking). The current use of inhalants, sedatives, pharmaceutical opioids in last one year was more than 1% each and of opium, heroin, cocaine, amphetamines, hallucinogens each was in 0.5% or lower. 
The age at initiation at first drug use was 17.1 ± 2.8 years and that for any illicit substances was 18.0 ± 3.1 years. The problems due to substance use were money loss, absenteeism, reduction in grades, medical problems, sadness/anxiety, fights, problems with peers or loss of friends, involvement in illegal activities, frequent anger outbursts, problem in relationship with parents, apprehended by police, failure in any class, given up entertainment activities, accidents.
Based on ASSIST score, 65.3% tobacco users, 27.8% alcohol users, 48.5% cannabis users needed brief intervention; 12.1% opioid user and 9.4% sedative users needed to receive intensive medical treatment. However, among the users, help seeking was poor and only 5% had sought any help. 
Conclusion
There is urgent need to have screening, brief intervention, referral to treatment being available in college settings. Colleges should be equipped with counsellors who are trained to do this activity and referral chain networks need to be established.