Substance abuse - A pressing concern among medical students

Substance abuse - A pressing concern among medical students

Mangalore Today News Network

By Dr. G. Shreekumar Menon

Mangaluru, Nov 8, 2025: A just published study at MGM Medical College Indore has linked substance abuse to a high number of sudden student deaths, while a separate study at Index Medical College Indore has brought to light high levels of substance use among students, particularly Interns. 36% of students were found to be users of alcohol, tobacco, or other substances. News outlets like Medical Dialogues reported the findings in early November 2025. 

Substance use among medical students is an important public-health and professional concern. Medical education places heavy academic and emotional demands on students, and substance use can impair health, professional conduct and future patient care. 

What were the Key findings from the Index Medical College study?

* Prevalence: 36% of the 400 medical students surveyed reported using a substance within the last six months.

* Substance type: The most frequently used substance was alcohol (47.2% of users), followed by smoked tobacco (26.6%), and chewable tobacco (9.3%).

* Academic level: Substance use was highest among interns and postgraduate students, with rates peaking at 93.3% for interns and 84% for postgraduates.

* Gender and influence: Use was higher among male students. Academic stress, peer pressure, and curiosity were cited as common reasons for substance use.

Medical students represent a population at elevated risk for substance use and misuse owing to the unique stresses of medical training, easy access to prescription medications, changing social environments, and cultural norms that is increasingly accepting alcohol and drug abuse as acceptable. Early adulthood is a peak period for initiation of substance use; for medical students this coincides with intense academic pressure, long clinical hours, sleep deprivation and exposure to clinical settings where prescription medicines are easily accessible.

The present survey was carried out as a cross-sectional, questionnaire-based study conducted among medical students of Index Medical College, Indore. Both undergraduate students from all years of the MBBS course, including interns, and postgraduate residents from different clinical and preclinical departments participated. The study was undertaken during a defined period, and all students enrolled in the institution during this time were eligible to participate. Before commencement, the protocol was submitted to and approved by the Institutional Ethics Committee of Index Medical College. Participation was voluntary, and all participants were provided written informed consent after being informed about the objectives of the study, the procedures involved, and the assurance of anonymity and strict confidentiality. The survey was strictly anonymous, and no identifying details such as names or roll numbers were collected to encourage truthful disclosure.

The survey brought to light the considerable prevalence of substance use among medical students at Index Medical College, Indore, with more than one-third of participants reporting current use within the past six months and nearly half acknowledging lifetime use. These findings indicate that substance use is not an isolated phenomenon but a significant behavioural pattern among future healthcare professionals. 

The increasing prevalence with advancing years of study is particularly worrying. Substance use was lower in the first and second years but rose sharply among students in clinical years, reaching its peak among interns and postgraduate trainees. This trend mirrors reports from other Indian institutions and international studies where the transition to clinical responsibilities, longer working hours, academic pressures, and greater social independence, led to alcohol and drug abuse. The steep rise among interns and residents underscores the role of professional stress, exposure to unhealthy hospital environments, and peer networks that compels consumption.

Peer influence has been repeatedly shown to be a major driver, as substance use is often initiated in social contexts. Academic stress, a common feature of medical training, has been associated with maladaptive coping strategies such as alcohol and tobacco use. Curiosity, particularly among younger students, also plays a role in experimentation, which may progress to regular use over a period of time. These motivational factors suggest that interventions must address not only knowledge gaps but also the psychosocial environment in which students make decisions about indulging in substance use.

The consequences of substance use among medical students extend beyond personal health. Regular consumption has been linked to absenteeism, poor academic performance, sleep disturbances, and interpersonal difficulties. In addition, substance use will impair clinical performance, judgment, and patient care, raising ethical concerns for proper professional conduct. International studies have raised alarms about the long-term impact of student substance use on professional life, with higher risk of later substance dependence, burnout, and professional misconduct. These implications reinforce the importance of addressing the substance issues during medical education, before patterns become deep rooted.

The study emphasizes the importance of institution-based surveillance and interventions. Colleges should incorporate preventive strategies, including orientation programs that address substance misuse, confidential counselling services, stress management workshops, and peer support groups. Routine screening and referral mechanisms can identify at-risk students early, while fostering a supportive environment that balances accountability with student welfare. Faculty sensitization and curricular inclusion of substance use disorders not only enhance student awareness but also reinforce their future role as physicians in addressing these issues among patients.

The findings from Index Medical College echo the larger body of evidence demonstrating that substance use has become a pressing concern among medical students. The high prevalence, particularly among senior students and male participants, the predominance of alcohol and tobacco, and the role of peer and stress-related factors all suggest that medical institutions must treat this issue as both a student welfare and a public health priority. 

India has approximately 816 medical colleges, with a total of about 1,37,600 MBBS seats for the 2025-26 academic year, following the approval of 41 new colleges and over 10,000 new seats. There are a total of 71 medical colleges in Karnataka, comprising 24 government colleges, 35 private colleges, and 12 deemed universities, according to data from 2025. These institutions collectively offer over 11,500 MBBS seats, with government colleges providing 3,750 seats and private and deemed universities providing the remaining 7,845 seats. There are a total of 33 medical colleges in Kerala, comprising 12 government colleges and 22 private colleges. Additionally, there is one deemed university medical college, making the total to 33. No surveys of any kind are taking place, hence the immensity of substance use is not clear. The substance use of the medical students could have far-reaching consequences on the general population. It is therefore crucial to understand their patterns of substance use. While use does not necessitate abuse, it can still lead to impairment, affect the quality of care and be detrimental to patient safety. Doctors, nurses and those in allied health services require optimal cognitive performance due to the nature of their jobs, and the effects of alcohol and drugs on cognition are dependent on patterns of use. Binge drinking, hangovers, as well as intoxication and withdrawal will affect performance and have lasting detrimental effects on cognition and decision making.

Substance abuse often leads to most health, social, legal and financial problems. Generally, the specialties of surgery and internal medicine are linked to a higher prevalence of substance use. The intense nature of surgery and potentially being in life-or-death situations daily, may lead to increased substance use to help cope with work related stress. Additionally, potentially high workloads and long hours for internal medicine physicians may propagate unhealthy coping habits. Therefore, studies into habits of medical students and hospital work culture would be informative, including investigating workplace stigma and perceived support, as well measuring levels of workload and burnout among health care professionals.

All medical colleges should conduct periodical surveys in their institutions to detect and determine the prevalence of all kinds of substance abuse. Navigating the road to recovery from drug addiction can be a challenging journey, but the right interventions can offer strength, guidance, and reassurance. Medical professionals and experts often describe substance abuse not as a moral failing but as a complex and chronic disease with profound psychological, neurological, and social consequences. Given the potential negative impact of harmful substance use on health service delivery and on providers’ mental and physical health, institutions and government should devote resources and create constructive interventions to further understand and address the scope of these issues in healthcare providers.

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By Dr. G. Shreekumar Menon