Abstract—Substance Use Disorder (SUD) has become a global public health crisis. Existing Western medical treatments have limitations such as significant side effects, poor adherence, and high relapse rates. Traditional Chinese Medicine (TCM), with its advantages of multi-target effects, minimal side effects, and holistic management of body and mind, provides new approaches for the treatment of SUD. This article systematically reviews 18 related studies, summarizing TCM’s understanding of the etiology and pathogenesis of SUD. It holds that ‘addictive toxins’ damage qi, blood, and yin-yang, leading to disharmony among the internal organs, mainly affecting the heart, liver, spleen, and kidneys, often accompanied by pathological products such as phlegm, blood stasis, and dampness. Based on this, the article reviews clinical and experimental evidence of TCM interventions, including herbal formulas (such as Compound 511, modified Shenling Baizhu decoction, and Anshen formula), acupuncture (including electroacupuncture and auricular acupuncture), tuina (such as Yizhi Chan massage technique), and guiding exercises, in alleviating withdrawal symptoms, reducing psychological cravings, improving comorbid anxiety and depression, and restoring cognitive function. The mechanisms of action are discussed, primarily including regulation of neurotransmitter levels in the mesolimbic dopamine system (such as DA, 5-HT, NE, GABA), modulation of the BDNF signaling pathway to repair neuronal plasticity, regulation of circRNA expression profiles, and regulation of neuroinflammatory responses. This review finds that TCM treatment for SUD is effective and possesses unique advantages, restoring the body’s homeostasis through multi-level, multi-target integrated regulation.