Abstract
According to World Drug Report, an estimated 250 million people between the ages of 15 and 64 had used at least one substance in 2014. Approximately 29million people are suffering with substance use disorder with 207,000 deaths in 2014 [1] . In the NHS, Cannabis (3%) and opioids (0.7%) were the commonest illicit substances prevalent in India. Data from Drug Abuse Monitoring Survey observes that cannabis (11.6%), heroin (11%), opium (8.6%) and other opiates (6.3%) constitute the majority of drug use by treatment seekers other than alcohol (43.9%) in India [2] . Alcohol and non–medicinal use of psychoactive substance use has become a matter of serious concern in Sikkim. From unofficial estimates alcohol use has traditionally been prevalent among Sikkim’s population which is reflected in the national surveys. In Sikkim, prevalence of licit substance (tobacco & Alcohol) use is more common than the use of illicit substances. NFHS-3 has revealed a very high prevalence of current alcohol use at 45%% and 19% for males and females respectively in Sikkim. These figures are much higher than the national average of 32% and 2% in males and females. There is an increase in trend towards current alcohol use in particular from NFHS-2 to NFHS-3 which may be due to greater availability, accessibility, affordability, and social acceptability [3,4] . Though Sikkim was declared a smoke free state, the Global Adult Tobacco Survey (GATS India 2010) reported the overall prevalence of current tobacco use was 42% higher than the national average of 35% [5] . However, there is a growing recognition that newer substances are becoming popular among the younger generation. Epidemiological data on illicit substances is scarce and it is hard to draw any conclusion about the recent trends in illicit substance use pattern in Sikkim.
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