The patterns of substance use seem to be changing in Sri Lanka, likely due to recent years‟ rapid socio-economic development across the country. As part of a qualitative study on alcohol‟s role in self-harm, this abstract explores socio-cultural patterns of alcohol and drug use in rural and semi-urban communities in the North Central and North Western provinces of Sri Lanka. Findings build on empirical data which include 10 gender and age segregated focus-group discussions with community members in rural and semi-urban communities and observations in villages, alcohol-selling establishments and at social gatherings.

Throughout the findings, alcohol and drug use was exclusively for males, deemed inappropriate for females. The types of substances consumed were linked to age, social position and geographical location. The cheap and strong „kassipu‟ (illegally produced home-brew) was explained to have been the preferred stimulant for mainly poor, adult men in rural communities. However, after government efforts to come down on sellers and consumers, obtaining this alcohol had become difficult in several areas. A preferred substitute was low-cost, legal spirits that had been introduced to the marked in recent years. Kassipu was – especially by young men –verbalized as being foul-smelling, more addictive than legal alcohol and associated with an older generation, limited education and low social status. Boys and young men preferred beer and experimented with different types of substances, such as over-the-counter medicines and cannabis-induced tobacco - the latter mainly in semi-urban settings. While such experimentation with drugs was understood by them to be “cool”, the older generation perceived them to be school drop-outs, from „broken‟, immoral families with too much money on their hands. For all ages, alcohol and drug use typically took place after working hours in groups away from home. While women were not in favor of daily drinking and its consequences on family life, men drinking at functions and social occasions were highly accepted by both genders and all ages.

Types and patterns of alcohol and drug consumption are thus age, area and gender specific and linked to social position in these Sri Lankan settings. This must be accounted for when developing prevention and treatment measures targeting the harmful use of it.