Background and Objectives: Comorbidity of substance use disorders (SUDs) and psychotic disorders (PDs) presents many challenges in diagnosis and treatment. Most reports to-date focus on the prevalence of SUDs among clinical populations of patients with PDs, and there is a lack of data pertaining to rates of PDs among individuals with substance use and SUDs.

Methods: We analyzed data on 43,093 respondents age 18 and above from the National Epidemiologic Survey on Alcohol and Related Conditions, a nationally representative US survey (Wave 1, 2001–2002). Cross-tabulations were used to derive prevalence estimates of PDs among individuals with 12-month substance use or SUDs across 10 categories of substances. Odds ratios (ORs) were derived from bivariate logistic regression analyses to examine the relationships between lifetime PDs and 12-month substance use or SUDs for the specific categories of substances.

Results: Among individuals with 12-month substance use, prevalence of PDs was found to be elevated in 8 of 10 categories of substances, particularly among amphetamine (OR = 8.8) and cocaine (OR = 10.3) users compared to nonusers. Among individuals with SUDs, prevalence of PDs was elevated in 9 of 10 categories of substances compared to individuals without SUDs.

Conclusions and Scientific Significance: Our findings on the increased rates of PDs among substance users and individuals with SUDs across a wide range of substances emphasize the importance of screening for PDs while treating patients with substance use and SUDs. This may allow for early intervention and adequate referral to appropriate settings. (Am J Addict 2012;21;531–535)