Substance abuse and the opioid crisis impacts every country in the world, both developed and developing. Traditionally, studies investigating how substance abuse impacts respiratory diseases have focused solely on tobacco smoking. However, many other substances such as alcohol, cocaine, marijuana and opioids can also cause respiratory problems. Frequently, these drugs are abused in combination with tobacco, and can exacerbate lung disease. The growing opioid crisis has increased opioid related morbidity and mortality. The International Narcotics Control Board has reported that addiction to prescription opioids is a problem worldwide (Dhalla et al, 2011). This session is designed for scientists, clinicians and health care providers to gain a better understanding of substance abuse and their contribution to the global burden of respiratory diseases.