Purpose of Review <p>This review synthesizes emerging evidence on the intersection between substance use disorders (SUD) and affective symptoms in the aftermath of the COVID-19 pandemic, focusing on epidemiological trends, clinical presentations, and health service adaptations.</p> Recent Findings <p>The pandemic amplified SUD–affective comorbidity through a dual mechanism: affective symptoms triggered by the crisis fostered initiation or escalation of substance use, while restrictions disrupted consumption patterns. Post-pandemic analyses show a decline in affective symptoms after a temporary peak in late 2020–2021, yet rates remain above pre-pandemic baselines. In contrast, substance use prevalence and diagnoses continue to rise. Among SUD patients, affective symptoms decreased following the lockdown surge. Telehealth expanded rapidly during the pandemic, with outcomes comparable to in-person care, though evidence in dual-diagnosis populations remains scarce.</p> Summary <p>Overall, affective burden appears to be stabilizing, while substance use continues to grow. Hybrid care models integrating telehealth and in-person treatment hold promise, but robust long-term evaluations and sustainable implementation strategies are urgently needed.</p>