Aims  To compare regard for working with different patient groups (including substance users) among different professional groups in different health‐care settings in eight European countries.

Design  A multi‐centre, cross‐sectional comparative study.

Setting  Primary care, general psychiatry and specialist addiciton services in Bulgaria, Greece, Italy, Poland, Scotland, Slovakia, Slovenia and Spain.

Participants  A multi‐disciplinary convenience sample of 866 professionals (physicians, psychiatrists, psychologists, nurses and social workers) from 253 services.

Measurements  The Medical Condition Regard Scale measured regard for working with different patient groups. Multi‐factor between‐subjects analysis of variance determined the factors associated with regard for each condition by country and all countries.

Findings  Regard for working with alcohol (mean score alcohol: 45.35, 95% CI 44.76, 45.95) and drug users (mean score drugs: 43.67, 95% CI 42.98, 44.36) was consistently lower than for other patient groups (mean score diabetes: 50.19, 95% CI 49.71, 50.66; mean score depression: 51.34, 95% CI 50.89, 51.79) across all countries participating in the study, particularly among staff from primary care compared to general psychiatry or specialist addiction services (P < 0.001). After controlling for sex of staff, profession and duration of time working in profession, treatment entry point and country remained the only statistically significant variables associated with regard for working with alcohol and drug users.

Conclusions  Health professionals appear to ascribe lower status to working with substance users than helping other patient groups, particularly in primary care; the effect is larger in some countries than others.