Alcohol and Drug Use in Musicians: A Systematic Review

Musicians face unique psychological and professional challenges, which may increase their risk of substance abuse. Previous studies have reported that the prevalence of alcohol or drug use among musicians ranges from 13% to over 80%, depending on the substance, genre, and measurement tools. This systematic review includes studies on alcohol and drug use among musicians, summarizing their prevalence, associated factors, and the bidirectional impact on mental health. Following PRISMA guidelines, a total of 551 records were initially identified before screening and exclusion, and the review included 23 qualitative and quantitative studies published between 1959 and 2024, involving a total of 36,245 participants. The research results show that the incidence of substance abuse (especially alcohol and cannabis) among musicians is higher than that of the general population. Most studies concluded that this could be due to insufficient coping strategies, the unique challenges of their workplace, and the cultural norms of the music industry. Certain music genres and performance roles as well as economic instability also affect the substance abuse of musicians. Compared to previous studies, this review places more emphasis on the complex interaction between the psychological distress of musicians, their professional environment, and professional expectations. Future research should incorporate more longitudinal designs, include more multicultural backgrounds, and focus on the perspectives of musicians themselves. This review provides information for formulating mental health interventions and policies for the music profession.