Brazil is one of the largest countries in the world, and is home to significant demographic, social and cultural diversity, as well as intense regional inequality. The country has successfully tackled many of these challenges, and the positive repercussions of these developments on the health care system have been particularly evident over the past two decades. Significant advances have also been made in terms of drug policies. The Brazilian tobacco control policy is one of the most advanced in the world and has helped the country to reduce the number of smokers by one half over the past 30 years. However, the alcohol market remains unregulated and regional alcohol control policies are still very inconsistent, leading to increased alcohol consumption due to a combination of advertising, low cost and high availability. The recent increase in the use of illegal psychoactive substances has also led to higher rates of domestic and urban violence, crime and mortality. The public health system offers several treatment options for individuals with substance disorders, but important services, such as detoxification centers, have yet to be implemented in the country. The national debate about drug policy is still very theoretical in nature and lacks the technical foundation offered by scientific research. In conclusion, in spite of the significant progress made over the past three decades, Brazil still has a long road to travel before developing a consistent and effective drug policy. The aim of the present article was to review the relevant and interesting developments in Brazilian drug policy over recent decades and to discuss framework for future developments in terms of legislation in the area.