A cross-sectional case-control study of familial and childhood factors associated with substance use disorder status in an Ethnic population in Northeast India

Problem considered Substance use disorders (SUDs) are chronic conditions with psychiatric and health-related comorbidities contributing to global public health crisis. The Mizo tribe in Northeast India have significantly higher substance use than the national average. Adverse childhood experiences and family history of substance use may be associated with substance vulnerability, yet their role within this community remains underexplored. This study aims to explore factors associated with substance use within the unique sociocultural context of this vulnerable population. Methods This unmatched cross-sectional case-control study includes 404 participants {131 treatment-seeking individuals with SUD and 273 community-based Healthy Controls (HC)}. Descriptive statistics summarized key variables and associations were assessed using t-tests, chi-square tests, and Spearman's correlations. Multivariable binary logistic regression was used to identify factors associated with SUD status. Results Participants with SUD included a greater proportion of males and married individuals than the HCs. The assessment indicated higher tobacco, alcohol, and opioid use in the SUD group. Adverse childhood experiences such as verbal abuse (AOR = 3.39), parental divorce (AOR = 1.81), and household substance use (AOR = 3.28) showed significant associations with SUD status. Conclusions This study identifies factors associated with SUD highlighting the relevance of family history substance use and adverse childhood experiences within this context. Cultural practices related to early tobacco exposure are discussed as plausible contextual influences, but were not directly measured. The findings should be interpreted as associations rather than causal relationships and may inform future culturally grounded prevention strategies.