Understanding the Psycho-social and Cultural Factors of Substance Abuse in the State of Sikkim

Although the term substance can refer to any physical matter, substance abuse has come to refer to the overindulgence in and dependence of a drug or other chemical leading to effects that are detrimental to the individual's physical and mental health, or the welfare of others (Nutt, King, Saulsbury and Blakemore, 1998). The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) issued by the American Psychiatric Association, the DSM-IVTR(1994) defines substance dependence as "when an individual persists in use of alcohol or other drugs despite problems related to use of the substance, substance dependence may be diagnosed." followed by criteria for the diagnose (DSM-IVTR,1994).