Addiction is a chronic yet treatable disorder. Patterns of addiction, whether substance related or behavioural, vary among countries and regions. Addiction medicine practice and approaches used in management are not only different from one country to another but are influenced by other factors, including environmental ones. The COVID-19 pandemic is one of the major environmental changes that had an impact on addiction. In this editorial, light will be shed on three articles covering recent updates in addiction medicine, ranging from types of substances and service provision to inclusion of gaming disorder in ICD-11.

As defined by the World Health Organization, the Eastern Mediterranean Region (EMR), given its special geopolitical situation and internal/external conflicts, faces an increase in illegal activities such as drug production and trafficking, highlighting the need for a comprehensive understanding of the substance use situation. On the basis of a review of published papers between 2015 and 2021 we briefly review substance use in the EMR with special focus on the emerging drugs pertinent to this region, namely tramadol, captagon and khat.