Substance Abuse Patterns in Patients with Psychoactive Polysubstance Use: A Tertiary Hospital-based Study in India

Background: This study examined patterns and clinical characteristics of substance use disorders (SUDs) among patients attending a tertiary-care hospital. Methodology: We conducted a cross-sectional observational study of 100 consecutive adults meeting ICD-10 criteria for SUDs, recruited according to predefined inclusion and exclusion criteria. Severity of substance use and psychiatric symptoms were assessed with the Addiction Severity Index (ASI) and Brief Psychiatric Rating Scale (BPRS), respectively; alcohol misuse was screened using the CAGE questionnaire. We described prevalence patterns and evaluated associations with comorbid psychiatric symptoms. Results: Of 100 participants, 96% were male and 81% were aged 18–39 years. By ICD-10 category, opioid-related disorders were most frequent (59%), followed by alcohol-related (22%), other psychoactive substances (16%), and cannabis-related disorders (3%). Age group was strongly associated with primary substance (χ² = 100.192, p < 0.001), with opioid use more common in younger adults and alcohol use more prevalent in middle age. ASI scores were higher among opioid users (mean 0.65 ± 0.20) than among those with alcohol-related (0.42 ± 0.15) or cannabis-related disorders (0.38 ± 0.12), mean difference 0.23 (95% CI 0.14–0.32; p < 0.001). BPRS scores were highest in cannabis users (58 ± 14) and users of other psychoactive substances (60 ± 13), indicating greater psychiatric symptom burden (mean difference 11.2, 95% CI 6.5–15.8; p < 0.001). On CAGE screening, 82% scored ≥2, suggesting probable alcohol misuse even among participants without alcohol as the primary substance. Conclusion: In this tertiary-care cohort, opioid use disorder predominated among young men and was associated with greater addiction severity, while cannabis and other substance use were linked to higher psychiatric symptom burden. The strong overlap between substance use, psychopathology, and CAGE positivity supports routine psychiatric screening and integrated addiction care. Early use of ASI, BPRS, and CAGE may enhance detection and rehabilitation outcomes.