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This thesis aims to understand the frequencies and longitudinal trends of anxiety and depression in a community-recruited cohort of people who primarily smoke methamphetamine. The sub-studies included in this thesis examine factors associated with anxiety or depression in people who use methamphetamine, and factors associated with health service use for mental health reasons in people with moderate to severe anxiety or depression and use methamphetamine. This thesis also assesses the factors associated with changes in anxiety and depression in people who use methamphetamine over time.