This chapter examines the use of recreational drugs: alcohol, marijuana and nicotine by the older adult. The pharmacokinetics/pharmacodynamics of these drugs, their extensive interaction with prescription and over-the-counter drugs/dietary supplements, their exacerbation of age-related changes and their role in risk enhancement of a number of diseases are discussed. The data suggest that recreational drugs should be used with caution. Evidence supporting the beneficial health effects of low-dose use of recreational drugs, although mostly controversial, is presented. Abuse of recreational drugs and subsequent development of dependency or substance use disorder are discussed; suggested strategies for recovery are given.