Author: Dr. Manasi Aphale, Consulting Psychiatrist
Substance abuse remains one of the most pressing public health concerns
worldwide, affecting individuals, families, and entire communities. It involves the
harmful or hazardous use of psychoactive substances—including alcohol, tobacco,
drugs, and cannabis—that alter brain chemistry, function and behaviour. It is an issue
that requires consistent attention due to its relapsing nature. It requires the support of
one’s family and friends for them to successfully remain abstinent from addictive
substances. Despite widespread awareness, the use of these substances continues
to rise, especially among the youth. The vast pit of substance abuse usually begins in
a peer or social setting where young adults are introduced to the substance and the
downward spiral begins from there. These substances carry an aura of curiosity and
popularity, which attracts the youth.
Alcohol is the most widely researched substance with abundant data available
regarding its impact on individual and community level. Its excessive consumption
leads to physical damage to almost all major organs as well as psychiatric
manifestations such as cognitive decline, violence, induced psychosis and
depression. Alcohol Use Disorder is the second-most commonly identified mental
disorder among suicide decedents worldwide (the most common is mood disorder). 1
Tobacco, on the other hand, remains a silent killer. The WHO estimates that there
were 1.24 billion tobacco users globally in 2022. 2 According to the data provided by
WHO, around 267 million adults in India (29% of all adults) use tobacco, according to
the Global Adult Tobacco Survey India, 2016-17. 3 Smokeless tobacco is the most
prevalent form of tobacco use in India. 3
It increases the risk of various oral and GI cancers, cardiovascular disease, stroke
and dental problems.
Illegal drugs such as cocaine, heroin, and methamphetamine pose even greater
risks, causing severe physical and psychological dependence. Their use often leads
to social and economic decline, crime, and family breakdown. Cannabis occupies a
complex space in this conversation. Though legalized in several regions for medical
or recreational use, it still carries risks—especially for young users—such as induced
psychosis, reduced motivation, and mental health issues when consumed
excessively.
Addressing substance abuse requires a combined approach of education, early
intervention, and rehabilitation. Effective deaddiction programs are available to help
the individual quit these habits but these require motivation and consistent efforts.
Governments and communities must work together to promote awareness, provide
counselling, and ensure access to treatment programs. Reducing stigma around
addiction is equally vital; it allows individuals to seek help without fear or shame.
Substance abuse isn’t a personal failure—it’s a public issue demanding compassion,
understanding, and action.