Background and ObjectivesComorbidity of substance use disorders and depression is a common phenomenon. It is well known that opioid addiction is neurobiologically distinct from psychostimulant addiction. However, direct comparisons of comorbid depressive symptoms in patients with methamphetamine (METH) use disorder (MAUD) and heroin use disorders (HUD) have been lacking until now.MethodsA total of 353 patients with methamphetamine use disorder, 76 patients with HUD, and 203 healthy controls were recruited. The Beck Depression Inventory (BDI‐SF), the Desires for Drug Questionnaire (DDQ) and the short form of the Childhood Trauma Questionnaire (CTQ‐SF) were used to measure participants' depressive symptoms, drug craving, and childhood abuse or neglect, respectively.ResultsThe prevalence of depressive symptoms was 35.41% (125/353) in MAUD and 56.57% (43/76) in MAUD, significantly higher than the 22.66% (46/203) in healthy controls. Furthermore, there was a significant difference in the total BDI score between the MAUD and HUD groups (F = 5.02, df = 1, 372, p = .026). Among MAUD, years of education, history of incarceration, month of abstinence and negative reinforcement scores were associated with depressive symptoms (all p < .05). Among HUD, duration of drug use, childhood emotional abuse and sexual abuse were associated with depressive symptoms (all p < .05).Conclusions and Scientific SignificanceThe prevalence and correlates of depressive symptoms differ between MAUD and HUD, adding to the existing literature. Therefore, treatment and intervention programs should be designed to address these unique correlates in HUD and MAUD patients.