Prevalence of and Factors Associated With Substance Use Among Canadian Medical Students

To the authors' knowledge, this study is one of the largest and most comprehensive studies of medical student substance use. Canadian medical students reported similar rates of alcohol use, higher rates of cannabis use, and lower rates of tobacco and NPS use than Canadian postsecondary students. These findings matter because medical students' substance use may indicate their ability to cope with stress and their risk of burnout, and their patient counseling practices on substance use. For example, NPS use was associated with greater psychological distress and burnout and lower coping ability. However, higher resilience scores were unexpectedly associated with more substance use for all 4 substances queried, which warrants further study. Study limitations include the cross-sectional study design, potential response bias, the age of the data (2015-2016), the omission of alternative tobacco forms, and a uniform cutoff for binge drinking for men and women (≥5 drinks). In addition, future research should examine the association between other demographic variables, such as race and ethnicity, with substance use, explore the mechanisms and mediating factors for the observed associations, examine the prevalence of substance use disorders (in addition to use), and investigate the effects of interventions to reduce substance-related harms among medical students.