Supplementary Table 1.

Glossary for the specific contacts of pathways to care for treatment of addictive disorders

Nature of the Contact		Definition
Specialized Addiction Treatment Services (SAT)		These are tertiary care centers funded by the federal government and are exclusively designated for the treatment of addictive disorders and their comorbidities. These centers have a multidisciplinary team of psychiatrists, psychologists, social workers, nurses, and/or general internists. Outpatient and inpatient services are available at these healthcare services. Cenetrs from Chandigarh, Ranchi, and Tezpur are in this category.
Mental Health Services with Specialized Addiction Treatment Services (MHSAT)		These centers are public-funded tertiary care general hospitals psychiatric units; these centers have specialized treatment facilities for addictive disorders and their comorbidities. They also have a multi-disciplinary clinical team. There are outpatient and inpatient services. The rest of the study sites represent this healthcare category.
Public-funded Addiction Treatment Services (PFAT)		State-funded addiction clinics/opioid agonist treatment centers/detoxification centers can be co-located with district-level hospitals or structurally separate from other health services. They usually offer outpatient treatment. These health services may not have permanent psychiatrists.
Mental Health Services (MHS)		These are public-funded psychiatric hospitals and medical colleges. Often, these centers lack specialty addiction services.
Private Psychiatrist/Private addiction treatment center (PP/PAT)		Privately-funded, for-profit psychiatric clinic/psychiatric nursing home/addiction clinics/private psychiatry practitioners. The private addiction centers may or may not have accreditation. Private psychiatrists may not have adequate training to screen and treat people with SUD.
Religious/Traditional Healers		Religious and native healing practices encompass various spiritual approaches. These practices are deeply rooted in the beliefs and traditions of various cultures and often involve rituals, ceremonies, and natural remedies. Some examples include faith healing, Ayurveda, etc., These practices may involve prayer, herbal remedies, rituals, etc.,
General Hospital		These are state-funded district-level hospitals providing secondary-level care. District hospitals may have psychiatrists but do not have a multidisciplinary team. Treatment is usually outpatient-based.
Primary Health Centres		These outpatient-based healthcare services are at the block level (sub-district) and funded by the state. These do not have mental healthcare professionals. A doctor (with an undergraduate degree), nurse, and pharmacist are available at this level. There is no or minimal training for SUD screening and treatment at the undergraduate level in the Indian medical curriculum.
Emergency Services		State-funded acute care services at the district hospital level. Undergraduate medical doctors are available at this level.
Private Medical facilities		Are private for-profit enterprises involving general physicians and surgeons but not psychiatrists.
Pharmacists		These are individual pharmacists who run local for-profit dispensaries. Many of them may not have formal pharmacy training.
Social work		Not-for-profit NGOs operate integrated rehabilitation centers for addicts. They deliver psychosocial interventions, primarily by social workers. The federal government funds these centers.
Self-medication		People with SUD can buy over-the-counter medications from local private pharmacies/drug stores.
Criminal justice		The Narcotic Drugs and Psychotropic Substances (NDPS) Act of India criminalizes drug use (and possession). The act has the provision of one-time immunity to people with SUD if they volunteer for treatment in a public-funded healthcare service.