Substance use disorders (SUDs) remain a global public health challenge, with traditional treatment methods often hindered by barriers such as accessibility, stigma, and cost. Telemedicine and online interventions offer promising alternatives to overcome these obstacles. These technologies provide flexible, accessible, and private treatment options that can rival traditional approaches in efficacy. Research indicates that telemedicine achieves comparable outcomes in terms of abstinence rates and treatment retention, while also expanding access to underserved populations. Benefits include reduced stigma, cost-effectiveness, continuous monitoring, and enhanced patient engagement. However, challenges such as technological barriers, regulatory constraints, and maintaining high standards of care must be addressed. Future directions involve integrating telemedicine with traditional care, advancing personalized medicine through data analytics, and fostering policy adaptations to ensure equitable access. Telemedicine thus represents a transformative innovation, with the potential to significantly enhance SUD treatment outcomes globally.