Objectives. To investigate experiences of substance use, bullying and psychological distress in adolescents. Differential patterns of substance use and levels of psychological distress were explored according to bullying status (bullies, victims, bully-victims and controls). There is little previous research exploring the relationship between bullying and substance use.\ud \ud Design. A between groups cross-sectional design was employed.\ud \ud Method. Students aged 13-16 years were recruited from several inner city schools. 263 students completed the Revised Olweus Bully/Victim Questionnaire, the Birlesen Depression Scale, the Spence Children's Anxiety Scale, the Rosenberg Self-esteem Scale and a measure of substance use designed by the researcher.\ud \ud Results. Victims and bully-victims were significantly more psychologically distressed, with higher levels of anxiety, depression and lower self-esteem, than bullies or controls. Those participants with higher levels of psychological distress used stimulants and hallucinogens more frequently than those with lower levels of psychological distress. There was no significant positive correlation between victim-hood and bully-victimhood with frequency of substance use. A negative correlation was found between victim-hood and use of hallucinogens and depressants. Being a bully was found to be positively correlated with use of depressants. Finally, reasons for substance use appear to vary according to bullying status. Bullies used substances to 'have a good time' and 'fit in with friends'. Victims used substances to 'block out bad things that had happened to them' and to 'block out negative feelings'. These results highlighted the unique identifiable patterns of substance use according to bully and victim status. However, bully-victims did not appear to have a unique pattern of substance use.\ud \ud Conclusion. Clinical implications of the results include the recognition of a complex association between substance use and bullying. Clinical services are encouraged to consider the differential patterns of substance use according to bullying status, and the subsequent requirement for different interventions and prevention strategies
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