There is clear evidence that co-morbid substance use in individuals with bipolar affective disorder (BPAD) leads to poorer symptomatic and functional recovery. Understanding this behaviour is imperative as individuals with BPAD type I have significant risks around substance abuse. This study in a sample (n=75) of first episode mania (FEM) patients treated through ORYGEN Youth Health investigated whether substance use and abuse were predictive of poorer symptomatic, psychological and functional outcomes at 12 and 18 months following FEM. A range of measures were used to assess recovery including YMRS, BPRS, HDRS, GAF, SOFAS, QOL amongst others. The results indicated a high incidence of substance use and abuse at both baseline and follow up. The impact of this behaviour was significant and the effects of this on varying measures of recovery will be discussed to assess whether these behaviours are correlated with poorer outcomes following FEM.