Prevalence and Patterns of Substance Use Among Young Adults Aged 18–35 Years Attending the Psychiatry Outpatient Department in Almora, Uttarakhand: A One-Year Retrospective Record-Based Cross-Sectional Study

Background: Young adulthood is a critical period for initiation and consolidation of substance-use behaviours. Facility records can provide locally actionable information where population-based data are limited. Material and Methods: A one-year retrospective record-based cross-sectional review was designed for young adults aged 18–35 years attending a psychiatry outpatient department in Almora, Uttarakhand. Unique index records of Almora residents were included. Documented substance use comprised current, past, or ever use with unclear timing. The primary denominator consisted of records in which substance use had been assessed and its status was known. Prevalence was reported with Wilson 95% confidence intervals (CIs). Associations were examined using chi-square or Fisher exact tests and exploratory multivariable logistic regression. Results: Of 500 eligible unique records, 480 (96.0%) contained an assessed and known substance-use status. Sixty patients had documented substance use, giving a prevalence of 12.5% (95% CI 9.8–15.8%); current use was documented in 52 patients (10.8% of the assessed denominator). Prevalence was 21.8% among males and 3.3% among females (odds ratio 8.06, 95% CI 3.74–17.40; P<0.001). Male sex remained independently associated with documented use (adjusted odds ratio 8.17, 95% CI 3.76–17.74). Among users, any tobacco use was recorded in 70.0%, alcohol in 38.3%, opioids in 30.0%, and cannabis in 13.3%. Polysubstance use involving two substance groups was present in 70.0% (95% CI 57.5–80.1%). Mean age at first use was 18.7±2.2 years. Harmful use or dependence was recorded in 45.0%. Conclusion: The review dataset indicates a clinically important burden of documented substance use among young adult psychiatry outpatients, marked by a major male excess, tobacco predominance, and frequent two-substance use. Routine standardized screening, brief intervention, and clearly documented referral pathways are warranted. These findings require confirmation in verified clinical records before scientific submission.

Keywords: Substance use; young adults; psychiatry outpatient department; tobacco; polysubstance use; retrospective study; Uttarakhand.