This study examined substance-use patterns and their associations with coping dimensions, perceived social support, and selected sociodemographic characteristics among individuals in Saudi Arabia. Tobacco cigarette use was the most commonly reported substance, followed by hashish, heroin, pregabalin/Lyrica, methamphetamine, and amphetamine. This pattern is consistent with recent Saudi literature indicating that substance-use patterns are evolving and include both commonly reported substances and increasing concerns related to stimulants, cannabis-related products, and prescription medications.^1-5,15 The presence of methamphetamine and pregabalin/Lyrica among the commonly reported substances is clinically relevant because it reflects the importance of monitoring substances that may be linked to changing availability, peer influence, self-medication, or polysubstance-use patterns in younger populations.

Gender-related differences were observed for selected substances. Male participants reported a higher prevalence of tobacco cigarette use, whereas female participants reported higher prevalence of hashish, heroin, ecstasy, and qat use. ¹⁶ These findings should not be interpreted as evidence that gender independently determines substance-use patterns, particularly given the small female subgroup. However, they raise important questions about gendered pathways into substance use, disclosure, and help-seeking. Previous Saudi and regional studies have emphasized the importance of gender and sociocultural context in understanding substance-use patterns, access to support, and treatment-seeking behaviors.^1,5,15,17,18 Therefore, the observed gender differences may reflect not only substance preference or exposure, but also differences in reporting, visibility, social acceptability, and pathways to care. ¹⁹

Perceived social support differed by gender, with male participants reporting higher MSPSS total and subscale scores than female participants. This finding is important in the Saudi context, where family and social networks can function as both protective resources and sources of pressure depending on the nature of the relationship and the sensitivity attached to substance use. Recent international evidence also suggests that perceived social support may differ according to addiction type and the number of addictive behaviors, supporting the need to interpret social support as context-specific rather than uniformly protective. ²⁰ In the present study, lower perceived support among women may indicate gender-related barriers to disclosure, support-seeking, or perceived emotional safety within available social networks.

Perceived social support level was associated with several substance-use categories. Participants with high perceived support were less represented among those reporting hashish, heroin, methamphetamine, amphetamine, ecstasy, crack, LSD, and cocaine use, whereas tobacco cigarette use was more common among participants with high perceived support. This pattern suggests that the relationship between social support and substance use may differ according to the type of substance and its social meaning. Tobacco cigarette use may be more socially visible or normalized than other substances, while substances that are more legally or socially sensitive may be associated with secrecy, social withdrawal, or reduced perceived support. This distinction suggests that social support should not be treated as a single uniform protective factor across all substance-use categories.

Coping dimensions were also associated with substance-use patterns. Tobacco cigarette use was associated with higher problem-focused, emotion-focused, and avoidant coping scores, whereas most other substance-use categories were not significantly associated with coping dimensions. This finding suggests that participants who reported tobacco cigarette use may endorse a broader range of coping responses. However, this does not mean that their coping is necessarily more effective. The Brief COPE includes qualitatively different coping strategies, including active management, emotional regulation, support-seeking, avoidance, denial, and disengagement. ¹⁴ Recent psychometric work in substance-use populations also supports interpreting Brief COPE dimensions separately rather than reducing coping to a single total score. ²¹ In this study, the association between tobacco cigarette use and avoidant coping is particularly important because it may reflect stress-related or disengagement-oriented coping rather than adaptive regulation. Because the avoidant coping dimension includes two substance-use coping items, a sensitivity analysis was conducted after removing these items. The association between tobacco cigarette use and avoidant coping remained statistically significant, suggesting that the observed finding was not explained solely by the inclusion of substance-use coping items.

Perceived social support was positively correlated with problem-focused, emotion-focused, and avoidant coping. The strongest association was observed between perceived social support and emotion-focused coping. This may suggest that individuals who perceive greater support are more likely to engage emotional and interpersonal coping responses, such as seeking comfort, expressing distress, or using acceptance and reframing. However, the positive association with avoidant coping complicates a simple protective interpretation. A person may perceive support while also engaging avoidance, self-distraction, or disengagement, particularly when substance use is associated with shame, stress, or fear of disclosure. Recent qualitative work also shows that stigma can shape how individuals in substance-use treatment cope with disclosure, social judgment, and treatment engagement. ²² This supports the need for culturally sensitive interpretation of coping and support rather than assuming that higher coping endorsement always reflects better adjustment. Together, these findings suggest that coping and perceived social support among individuals who use substances may operate in complex and overlapping ways, rather than as purely adaptive or protective factors. This is particularly important in the Saudi context, where social support, disclosure, gender, and stigma may shape how individuals cope with substance-use-related stress.

The findings align with Lazarus and Folkman’s Transactional Model of Stress and Coping, which conceptualizes coping as cognitive and behavioral efforts used to manage demands appraised as stressful. ¹¹ Within this framework, perceived social support can be understood as a psychosocial resource that may shape stress appraisal and coping responses. The present findings suggest that perceived support and coping dimensions are connected among individuals who report substance use, but the nature of this connection appears complex. Support may facilitate more active or emotion-focused coping, but it may also coexist with avoidance when the individual’s social environment is experienced as judgmental, unsafe, or difficult to access.

Overall, this study contributes to the literature by highlighting the relevance of coping dimensions and perceived social support in understanding substance-use patterns among individuals in Saudi Arabia. The findings suggest that psychosocial factors should be considered alongside demographic and substance-related characteristics when designing prevention and support strategies. In particular, interventions may benefit from strengthening accessible support systems, addressing avoidant coping responses, and considering gender-related differences in perceived support and help-seeking needs. Future research should use larger, more gender-balanced samples and longitudinal or multivariable designs to clarify how coping, perceived support, and substance-use patterns develop over time.

This study has several limitations. First, the cross-sectional correlational design does not permit conclusions about causality, directionality, mediation, or prediction. Second, recruitment through social media and the English-language eligibility requirement may have introduced selection bias by favoring participants who were digitally connected, more educated, and able to complete an English-language survey. The use of English-language instruments may also have affected participant comprehension and cultural interpretation of some items and may have limited representativeness by favoring bilingual or more educated participants, even though internal consistency coefficients were acceptable to high in the present sample. Third, substance use was assessed using self-report, which may be affected by recall bias and social desirability bias, particularly in a context where substance use is legally and socially sensitive. Fourth, the sample was imbalanced by gender, with a small female subgroup, limiting confidence in gender-based comparisons. Fifth, the inclusion of both current and past substance use may have introduced heterogeneity because participants may have differed in recency, severity, treatment status, and recovery stage. Sixth, multiple bivariate comparisons were conducted across substance-use categories and psychosocial variables, which may have increased the risk of Type I error. Because the analyses were exploratory, no formal correction for multiple comparisons was applied; therefore, marginally significant findings should be interpreted cautiously. Although the sensitivity analysis excluding the two Brief COPE substance-use coping items produced a similar finding, the avoidant coping dimension should still be interpreted cautiously because these items may overlap conceptually with substance-use behavior in this sample.Finally, the analyses were primarily descriptive, comparative, and correlational; therefore, unmeasured confounders such as psychiatric history, trauma exposure, treatment history, socioeconomic stressors, and polysubstance-use severity may explain some observed associations.