Abuse related drug use is on the rise, which is worrying for global public health. Given that these organs are involved in their filtration, concentration and conversion to potentially harmful metabolites, they are particularly susceptible to the toxicity of these compounds. Several substances of abuse have been associated with various clinical symptoms that are known to presage acute and chronic kidney impairment, such as rhabdomyolysis, vasoconstriction, and decreased estimated glomerular filtration rate (e.g., cannabinoids, cocaine, opioids, substituted phenethylamines). The fundamental mechanisms, however, are still not well known.