The rate of substance abuse among Nigerian populace is quite alarming despite the associated consequences in all aspect of life which involve: physical, emotional, financial, spiritual social and psychological wellbeing hence, this study investigated self esteem as a predictor of substance abuse among patients in Nigerian army reference hospital, 113 participants comprises 93 military personnel and 20 civilians which comprises 88 SSCE and 25 Higher degrees (BSc., HND and OND), were sampled using availability sampling technique, this was used based on the patients who are still on first stage drug management in the hospital, urine base drug test and Montgomery County Court Referral Program substance abuse questionnaire was used to identify the substance used by patient, RSES (Rosenberg, M. 1965) was used to measure self-esteem while DAST-10 (1982) by the Addiction research foundation was used to measure the level of substance abuse, a regression statistical analysis with the help of SPSS version 26 was used in this study, however the result of this study shows that Self esteem did not predict substance at β= -.331, t= -1.717 and sig.= .099 at p< .05. Secondly only married persons self esteem predicted substance use because β= .560, t= 2.432 and sig. = .025 at p< .05, while others did not predict substance abuse single persons self esteem β= .126, t= .635 sig. = 533, ssce β= -.137, t= -.723 and sig. 478 and B.sc self esteem β= -.306, t= -1.289 and sig. = .212 at p< .05. Therefore recommend that substance abuse should not be used as a criteria in the measurement of self esteem among patience. Also in assessment, substance abuse should be considered in some behavioral maladjustment among married patients.