The paper provides an extensive overview of the neurological complications stemming from drug misuse, encompassing both illicit substances and prescription medications. It addresses the global prevalence of drug-use disorders and the increasing complexity introduced by new psychoactive substances like synthetic cannabinoids and potent opioids such as fentanyl. The document details the acute and long-term neurological manifestations associated with various drug classes, including opiates, stimulants, hallucinogens, and inhalants, outlining specific syndromes of toxicity and withdrawal. Furthermore, it discusses complications such as trauma, infections, seizures, strokes, cognitive impairment, and movement disorders, emphasizing the disproportionate impact on young individuals. The text underscores the critical importance for neurologists to promptly identify acute toxicity and comprehend the lasting consequences of drug-use disorders for effective patient care.