Substance abuse is a significant problem in Pakistan (Hussain, 2017), yet, there are few studies of risk factors in this population, particularly in remote areas. The Alcohol Use Disorders Identification Test (Babor, Higgins-Biddle, Saunders, & Monteiro, 2001), was used to quantify level of risk associated with use, and 22.6% of the sample had scores indicating significant risk levels. Logistic regression analyses indicated that lifetime alcohol use was associated with internalising problems (e.g., depression, anxiety), while risky alcohol use was associated with externalising problems (e.g., aggressive and delinquent behaviour). Attention problems were related to both outcomes. Implications for prevention are discussed.