Suicide is one of the major public health problems in Sikkim and the State has been facing the dramatic rise in suicide cases. According to the National Crime Records Bureau (NCRB) report, 2008 Sikkim had the highest suicide rate and in 2009, Sikkim (39.9) was recorded as second highest state in the country in terms of suicide. The major cause of concern in Sikkim is the unusually high rate of suicide. Alcohol use is traditionally prevalent among Sikkim's population. National Family Health Survey-2, Government of India, has also highlighted a significant prevalence of alcohol use in Sikkim-32% and 17% among above 15 years of age males and females, respectively. From their observations prevalence of alcohol use is more common in rural areas than urban and negatively related to level of education and socioeconomic condition. These rough estimates make it obvious that alcohol use has become an important public health issue in Sikkim. As a result, abuse of opioids including heroin and other synthetic opioids have been reported from treatment centers. Similarly injection drug use (IDU) behavior has also been reported. Therefore, this is an early attempt to address the problem of substance abuse and mental Health problem in Sikkim.