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Generalizing these findings to other regions like South America, where opioid and injection drug use is uncommon, is not straightforward. We examined if length of time in treatment and compliance with treatment reduced subsequent substance use and presence of psychiatric comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort analysis (3 assessments, 18\u2009months) using inverse probability weighting to account for confounding and loss to follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Settings<\/jats:title><jats:p>Outpatient\/inpatient programs in Regi\u00f3n Metropolitana, Chile.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Individuals initiating publicly funded treatment (<jats:italic>n<\/jats:italic>\u2009=\u2009399).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Exposures included length of time in (0\u20133, 4\u20137, 8\u2009+\u2009months, currently in) and compliance with treatment (not completed, completed, currently in) measured in the intermediate assessment (12\u2009months). Primary outcomes were past\u2010month use of primary substance (most problematic) and current psychiatric comorbidities (major depressive episode, panic, anxiety or post\u2010traumatic stress disorders) measured 6\u00a0months later (18\u2009months). Secondary outcomes included past month use of alcohol, cannabis, cocaine powder and cocaine paste.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>18.3% [95% confidence interval (CI)\u2009=\u200914.7%\u201322.6%] of individuals participated for 3 or fewer months in treatment and 50.1% (95% CI\u2009=\u200945.2%\u201355.1%) did not complete their treatment plan at 12\u2009months. Participating for 8\u2009+\u2009months in treatment was associated with lower risk of past month use of primary substance at 18\u2009months [vs. 0\u20133\u2009months, risk ratio (RR)\u2009=\u20090.62, 95% CI\u2009=\u20090.38\u20131.00] and completion of treatment (vs. not completed, RR\u2009=\u20090.49, 95% CI\u2009=\u20090.30\u20130.80). Neither participating 8\u2009+\u2009months (vs. 0\u20133\u2009months, RR\u2009=\u20090.83, 95% CI\u2009=\u20090.57\u20131.22) nor treatment completion (vs. not completed, RR\u2009=\u20091.02, 95% CI\u2009=\u20090.72\u20131.46) were associated with lower risk of psychiatric comorbidity at 18\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Longer time in treatment and compliance with treatment for substance use disorders in Chile appears to be associated with lower risk of substance use but not current comorbid psychiatric conditions 18\u2009months after treatment initiation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16731","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:44:48Z","timestamp":1736491488000},"page":"756-769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Substance use and psychiatric outcomes following substance use 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