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Because of ongoing neuromaturation, youth with chronic alcohol/substance use disorders (AUD/SUD) are at risk for cognitive decrements during young adulthood. We prospectively examined cognition over 10 years based on AUD/SUD history. Youth (N = 51) with no AUD/SUD history (n = 14), persisting AUD/SUD (n = 18), or remitted AUD/SUD (n = 19) were followed over 10 years with neuropsychological assessments. Groups were compared at baseline and 10-year follow-up. Both AUD/SUD groups declined in visuospatial construction at year 10 (p = .001). Further, cumulative alcohol use (p < .01) and drug withdrawal (p < .05) predicted year-10 visuospatial function. Alcohol use predicted verbal learning/memory (p < .05), while stimulant use predicted visual learning/memory (p = .01). More recent substance use predicted poorer executive function (p < .05). In conclusion, heavy alcohol and other substance use …