The neuroimaging window into the brain structure and physiology of alcohol and other substances abuse disorders has already provided a wealth of insight into the characterization of common and specific neuropathology. Magnetic resonance (MR) neuroimaging is uniquely suited for the delineation of the nature of alcohol and substance abuse induced neuropathology. Alcoholism is a lifelong disorder that interacts with the dynamic changes that occur in the brain throughout the life span from adolescence to senescence. Functional MR studies of craving during abstinence could provide predictors of prognosis for relapse and recovery. There are potential beneficial effects of many abused substances. Opiates are used to reduce pain; psychostimulants, including nicotine, are used to maintain alertness in dangerous battle conditions. Marijuana is used for nausea control and appetite stimulation; and alcohol in moderation has cardiovascular and cerebrovascular protective properties demonstrable with neuroimaging.