Illegal drug use was already a problem in the Baltic countries in the Soviet era, when the Iron Curtain was still in place. At independence the Baltic countries inherited drug treatment system, operated mainly by psychiatrists and based on inpatient system. As the Soviet treatment model was abandoned and professionals in the Baltic countries turned to the West, the drug treatment field became open to the Western drug treatment experience, especially from European countries and USA. Unexpectedly, they were to be exposed to different and often conflicting concepts of treatment modalities, which usually competed with one another in claims of being the most effective and useful. The question remains open as to which programs will be developed to meet the growing demand for treatment in each country and how widely they will be adopted.