In this article, the author presents an overview of substance-abuse education in U.S. medical schools. In the early 1970s, two nationwide conferences prompted an awareness of the need for improved medical education in substance abuse. The Council on Mental Health and the Committee on Alcohol and Drug Dependency, both of the American Medical Association, presented general guidelines for a curriculum in substance abuse. During the same era, the federal government sponsored a career teacher training program in drug abuse and alcoholism, and private foundation funding supported educational endeavors that resulted in long-term materials for teaching in medical schools. Three current programs that are improving drug-abuse education are described. These developments are good examples of efforts that should be considered for any medical school curriculum. Goals for the future should include some attempt to modify the institutions, both medical schools and hospitals, where patterns leading to physician impairment may develop.