The process of the Brazilian Psychiatric Reform initiated a fundamental discussion and review of models and practices of mental health care and interventions in Brazil. Previously, most of these had reliedon institutionalization, internment, and delivery of care by psychiatric hospitals, resulting in isolationand social exclusion of patients with mental health problems. These approaches were to be replaced or complemented by a range of community-based services and form a network of inpatient and out patient interventions better suited for the needs of patients. This new approach to mental health care was to achieve improved social inclusion of people suffering from mental health conditions that had under gone stigma, human rights violations, and even institutional violence for a long time within the larger context of Brazil, a country marked by extensive social inequalities. Unfortunately, the population struggling with alcohol and/or drug use problems or addiction issues has not been fully included in the discussion and process of the Brazilian mental health care reform, because much of it lives and continues to exist at the margin of society. Instead, substance use or addiction issues continue to be largely seen and approached as public safety or justice - rather than health - issues so far.