The aim of this systematic review was to evaluate the quality and efficacy of drama therapy interventions used to support and promote the recovery process in substance users. Seven databases plus two journals were searched; three studies met the inclusion criteria. It was found that drama therapy interventions commonly consist of expressive activities such as role-play and improvisation, along with group reflection to improve communication skills, emotional awareness, and metacognition. Findings were encouraging with two studies reporting that participants maintained or improved abstinence goals, quality of life was reported to be significantly higher postintervention compared with the control group (one study), and social and occupational engagement significantly improved postintervention and was maintained at a 6-week follow-up (one study). These results, however, should be interpreted with caution. Methodological inadequacies and the small number of published studies available make it difficult to determine with confidence the efficacy of these interventions.