The coronavirus disease (Covid-19) pandemic has caused suffering and pain to mankind leading to many individuals practising self-medication and substance abuse that could elevate substance use disorders (SUDs). This study assessed the impact of Covid-19 on SUDs among Kanyama residents of Lusaka district, Zambia. We conducted a retrospective cross-sectional study using patient files at Kanyama First-Level Hospital from September 2021 to October 2021. Data analysis was done using IBM SPSS version 26.0. Of the 101 participants, 86.1% were male. The study showed that Covid-19 had an impact on SUDs with alcohol (83.2%) being the most abused substance. There was no significant difference in the type of substances abused (p=0.870) and intoxication symptoms (p=0.331) between the pre-Covid and post-Covid groups. There was a significant difference between substance use (p=0.001) and withdrawal symptoms (p=0.002) in both cohorts, with the post-Covid group consuming more substances and experiencing more withdrawal symptoms. Factors that influenced substance abuse included recent unemployment (p<0.001), boredom (p<0.001), overcrowding at home (p<0.001), and gender-based violence (p<0.001) influenced the change in the pattern of substance use. Recreational use was not associated with a change in the pattern of substance abuse (p=0. 667). This study found that the Covid-19 pandemic increased the practices of substance abuse among Kanyama residents, especially those who were unemployed, bored, overcrowded at home and experienced gender-based violence. There is a need to heighten the monitoring and restriction of substance use, especially among adolescents and youths to curb some mental health problems. Keywords: Covid-19; Pandemic; Self-medication; Substance abuse; substance use disorders; Zambia.