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Substance Use Disorder (SUD) is a serious public health problem in India. The present study was planned to study the socio-demographic, clinical correlates and predictors of adverse outcomes in all new patients attending the De-addiction clinic in a tertiary hospital in Eastern India. All new patients visiting the De-addiction clinic were assessed and interviewed. Four groups were made viz Alcohol, Opioid, Cannabinoid and Other SUDs. A total of 200 patients were included in the study, of whom majority were males. A positive family history of substance use was evident in 44.1% of the patients in the Cannabinoid group. The mean duration of use was 180.87 ± 95.64 for the alcohol group, 78.70 ± 66.41 for the opioid group, 94.0 ± 85.70 for the Cannabinoid group, 104.2 ± 79.37 for other SUDs. The most common substance used was alcohol (n=117). Our findings suggest that the initiation of substance use occurs during late teen age years and early 20s in case of Opioid and Cannabinoid group and in case of Alcohol group in their early 30s. In our study, poor social support correlated with family complications, marital complications and social complications. Motivation clearly and significantly correlated with financial, family, marital and social complications suggesting that motivation to leave alcohol/drugs is influenced by these factors. The motivation level influenced follow-up rates with poor to superficial motivation predicting poorer follow up rates. On the other hand good and fair motivation correlated with increased adherence to attending Group therapy. Motivation to leave drugs/alcohol correlated with drop-out & relapse rates with poorer outcomes in form of relapses and drop out related to poor motivation to leave drugs. Financial security in form of employment is critical for adherence to treatment and follow-up rates which in turn influences recovery and rehabilitation. Motivation is cornerstone to relapses and management of motivation enhancement and adherence to treatment can reduce relapses.

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Background : Psychiatric comorbidities are not very uncommon particularly in alcohol dependent patients. They are sometime very difficult to treat and overall prognosis is unpredictable most of the time.Aims : To measure the prevalence of several psychiatric comorbidities in patients with alcohol dependence.Settings and Design : The study assessed the prevalence of psychiatric comorbidities among 100 alcohol dependent patients admitted in Institute of Psychiatry, Kolkata.Methods and Material : A semistructuredproforma and Structured Clinical Interview for DSM-IV (SCID) diagnostic tools were used among alcohol dependent patients who met inclusion and exclusion criteria.Statistical Analysis used : Statistical analysis was done by using Statistical Package for Social Sciences (SPSS).Results : The psychiatric comorbidities among alcohol dependent patients were depression (32%), Bipolar affective disorder (20%), Anxiety disorder (18%), Personality disorder (10%), Schizophrenia (10%).Conclusions : Most of the patients in this study were males. Those of (V-X) educational standard, male persons of mean age group 25.4 years and having monthly family income of Rs 1,000 - 5,000 were most vulnerable group of alcohol dependence with comorbidities. The most common psychiatric comorbidity was depression (32.5%).Key Message : Alcohol abuse is a great worldwide problem and psychiatric comorbidities arenot uncommon with alcohol dependence. However, the co-morbidity with substance problemsis underreported and understudied. Early detection and prompt intervention to treat alcoholdependence is essentially needed to overcome this burning problem.