Behind the white coat: the effects of substance use and alcohol among South African medical students

Substance use, and alcohol bingeing are growing concerns among medical students globally, with significant implications for their mental health. International studies have reported high prevalence rates of substance use (30–50%), with alcohol bingeing being particularly prominent among students. However, in the South African context, research exploring this intersection is sparse, and the unique socio-cultural and healthcare environment may shape patterns of substance use in ways that differ from other regions. This scoping review aims to review the relationship between substance use, alcohol bingeing, and mental health among South African medical students. A scoping review was conducted according to the Joanna Briggs Institute (JBI) protocol, and articles were searched from PubMed, Scopus, and PsycINFO databases. A comprehensive search of academic databases was conducted to identify studies published between 2010 and 2024 that address substance use, alcohol bingeing, and mental health among South African medical students. Inclusion criteria focused on peer-reviewed articles, theses, and reports that provided empirical data or relevant insights. Only five relevant studies met the inclusion criteria in this study. Using a thematic analysis, only three themes emerged: prevalence and patterns of substance use and alcohol bingeing; factors contributing to substance use and mental health issues; and impact on mental health. This review highlighted that 42% of South African medical students engage in binge drinking, and 38% use substances like cannabis, contributing to higher rates of anxiety (48%) and depression (53%). These findings emphasize the urgent need for integrated mental health support and substance use prevention programs in medical schools.