en other Orginal research <strong><em>Background:</em></strong> Substance abuse has a reciprocal association with the individuals&#39; general health; and its incidence among medical students is highly variable over time.<br> <strong><em>Objectives: </em></strong>The present study aimed to investigate the factors involved in the substance abuse and its association with medical students&#39; general health<span dir="RTL">.</span><br> <strong><em>Methods:</em></strong> The present mixed-method study was conducted on the medical students of Azad University of Tabriz in 2018 with Stratified Random Sampling. Data were collected using the General Health Questionnaire-28 (GHQ-28) and a researcher-made substance abuse questionnaire and then was analyzed through tests, chi-square, ANOVA, post hoc Howell Games and Multivariate regression models were using the SPSS16.<br> <strong><em>Results</em></strong><strong>:</strong> 150 medical students with a mean age of 26.98<span dir="RTL">&plusmn;</span>3.46 are participating in the present study. 17.3% of students were substance abusers. The highest rate of abuse was related to Ritalin. The mean scores of the general health of addicted and non-addicted students were 42.65<span dir="RTL">&plusmn;</span>11.95 and 23.62<span dir="RTL">&plusmn;</span>16.83 respectively, and it was statistically significant (p= 0.012). Academic pressure was the main reason for Substance Abuse. Anxiety and insomnia were the most essential predictors decreasing general health among students with substance abuse.<br> <strong><em>Conclusion:</em></strong> The prevalence of substance abuse among medical students was unexpected. Medical students are at risk of addiction due to the inadequate distribution of academic pressure and other predisposing factors. The implementation of practical strategies in training environments, families, and society is very important to prevent and improve the current status<span dir="RTL">.</span> medical students, substance abuse, addiction, general health, public health 1 8 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-633-4&slc_lang=en&sid=1 Sepideh Herizchi sherizchi@gmail.com 10031947532846007327 10031947532846007327 No Associate Professor, Department of Psychiatry, Razi Hospital, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan Ghader Dargahi Abbasabad Ghaderdarghahi@yahoo.com 10031947532846007328 10031947532846007328 No Msc of Epidemiology, Research center of psychiatry and behavior sciences, Razi hospital, Tabriz University of Medical Sciences, Tabriz, Iran Parvin Delnavaz Pdelnavaz71@gmail.com 10031947532846007329 10031947532846007329 No Department of Pediatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran Hojjat Torkmandi hojjat.or@gmail.com 10031947532846007330 10031947532846007330 No Department of Operating Room, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran Sina Dezhampor s_dezhampoor@yahoo.com 10031947532846007331 10031947532846007331 No Psychiatry residents, Razi Hospital, Tabriz University of Medical Sciences.Tabriz, East Azerbaijan Bahman Roshenas m.abdi252@gmail.com 10031947532846007332 10031947532846007332 No GP, Razi Hospital, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan Rahele Modaber r_modaber@yahoo.com 10031947532846007333 10031947532846007333 No MSc of Psychiatry Nursing, Razi Hospital, Tabriz University of Medical Sciences, Tabriz, East Azerbaij Mohammad Abdi Mohammad2016@yahoo.com 10031947532846007334 10031947532846007334 Yes RN, MScN, Department of Emergency and Critical Care, Faculty of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran