There is a growing body of knowledge on the prevalence of substance use disorders in many developing countries. Recent studies show that alcohol and drug use disorders are increasing in many of these countries, and that they are experiencing an increasing burden of health burden attributable to harmful use alcohol other drugs. But there is scant information on prevention, treatment and rehabilitation of these problems in developing societies. This paper presents available data from a variety of sources on the nature of the problems in selected countries, responses to these problems, and approaches to addressing the treatment needs of dependent persons. Particular attention is given to screening and brief intervention in primary care settings as it is practiced in some of these countries and as the platform on which the future of interventions seems to lie. In addition, the paper addresses the low level of acceptance of opioid substitution therapy and calls for more research on treatment and the adoption, at the national health policy level, of practices and techniques that have been shown to be effective.