Harmful use of psychoactive substances is a pattern of use that is causing damage to physical and/or mental health. Psychoactive substance use and substance use disorders can result in a wide range of problems for individuals, their families and wider community (WHO 2004). Worldwide, about two billion people use alcohol. Between 172 and 250 million people used illicit drugs at least once in 2007. Harmful alcohol use accounts for 4.5% of the global burden of disease and is responsible for 3.8% of all deaths (WHO 2009). Psychoactive substance including illicit drug use is associated a wide range of social and health problems and disorders both in developed and developing world (WHO 2004, 2007 and UNODC 2008, 2009). Injecting drug use is closely linked to blood-borne viruses such as HIV and hepatitis B and C transmission (EMCDDA 2008). Dependence, overdose and serious mental health problems are amongst the main health risks (Seivewright N et al, 2004). This article summarizes the key findings on involvement of nurses and midwives in screening and brief interventions for hazardous and harmful use of alcohol and other psychoactive substances. They identify entry points for expanding the role of nurses and midwives to include brief interventions for prevention and treatment of disorders resulting from harmful use of psychoactive substances in their daily practice.