ABSTRACT Objective: to analyze the relationship between alcohol and other drug use, and mental distress among women. Method: an analytical cross-sectional study conducted with 369 women in Piauí State. Alcohol Use Disorders Identification Test, Non-Student Drugs Use Questionnaire and Self-Reporting Questionnaire and inferential statistics were used. Results: women with heavy alcohol consumption (zone IV - possible dependence) are 2.1 times more likely to have mental distress. Consuming tobacco increases the odds of distress 3.5%, tranquilizers 2.6 times and cannabis 4.5 times. There is a statistically significant and positive correlation between the Alcohol Use Disorders Identification Test score and the Self-Reporting Questionnaire (p = 0.000; r = 0.250). Conclusion: alcohol, tobacco, tranquilizers and cannabis use is associated with mental distress. The more intense the alcohol consumption, the more intense the mental distress. Therefore, it is necessary to track alcohol and other drug consumption, and mental distress in the routine care of women.