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Substance use is among the risk factors associated with both HIV/AIDS and non communicable diseases (NCDs). The aim of this paper is to describe the development of the medication assisted therapy (MAT) in the treatment of substance use disorders and opportunities for further interventions in Tanzania.

A review of MAT pilot project documentation, existing published and grey literature on substance misuse in Tanzania was used to describe the scope of this paper. MAT as a program focuses on the treatment of opiod dependent individuals using methadone in a national hospital in Tanzania. It is delivered by a team of trained interprofessionals coordinating with community partners.

The findings indicate an uptake of pharmacotherapy in the treatment of substance use disorders as an adjunct to traditional counseling approaches in low resource settings. Program acceptability and reach within a short period of time by the opiod dependent individuals is shown.

National buy‐in is critical for developments of new interventions. Given adequate resources, it is feasible to integrate MAT for the treatment of substance use disorders within health care systems in poor resource settings. To ensure the success of the program, sustainable efforts and scaling up to include alcohol and tobacco dependence treatment is crucial. The local capacity building is required including a need for designing appropriate policies to address alcohol and tobacco use in Tanzania.

The intervention is the only one in sub‐Saharan Africa. MAT may serve as a practice model for other countries in the region.