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Context: Medical education is highly stressful and demanding as a career. Although, only the academically-minded youth in the society tend to be selected for medical education, the stressful academic environment can exert a negative effect on the psychological and physical well-being. There is growing concern about substance use/dependence among medical students. While medical students and doctors help patients resolve substance dependency, they are not immune to these temptations themselves. In addition to negative effects on the individual’s physical and mental health, and on their families, substance abuse may threaten the ability to provide adequate patient care, and it may undermine the individual’s role as a role model for healthy lifestyles. Aims: To assess the stress and substance use and association among them among undergraduate medical students. Settings and Design: It was a cross sectional study with second, third and final year undergraduate medical students of a government medical college in Northern Karnataka as subjects. Materials and Methods: Basic demographical data was collected using a semi structured questionnaire, substance use was assessed using WHO ASSIST 3.0 scale, stress was assessed using Medical Student Stressor Scale (MSSQ). Statistical analysis used: Data was compiled and appropriate statistical tests were used to analyse the data with the help of SPSS 20. Results: Out of 450 second, third and final year undergraduate medical students, 403 participated in the study. The prevalence of substance use was about 34.7% with alcohol being the leading substance followed by marijuana. Few students reported inhalant/volatile substance use. 65% of the subjects reported high stress. Stress was almost equal in almost all domains. Conclusions: Effective interventions have to be planned and implemented to reduce stress levels among medical students and to address the issue substance use by promoting healthy life style and coping skills. Key Messages: There is association between stress and substance use among undergraduate medical students. Effective interventions have to be planned and implemented to reduce stress levels among medical students and to address the issue substance use by promoting healthy life style and coping skills.

Stress and substance use among undergraduate medical students in a Government medical college in Northern Karnataka