Brazil has one of the highest rates of illicit drug consumption and is considered a major corridor for the trafficking of illicit drugs worldwide. Thus, this article reviews the literature on the consumption, distribution, and main environmental impacts of illicit drugs in Brazil and analyzes the III National Survey on Drug Use by the Brazilian Population. The literature review is based on articles published in national and international journals between 2018 and 2023. This review consists of two analyses, the first of which addresses publications from the last six years on the monitoring of illicit drugs in Brazil and a second analysis based on the III National Survey on Drug Use that addresses the different possibilities of contact with drugs. The results revealed that the Southeast region of Brazil has the highest number of studies on the subject, especially in the state of São Paulo, while the North and Northeast regions have the lowest number of studies. The Midwest regions only have studies in the federal capital city, Brasília, while no studies were found in states bordering countries that produce illicit drugs, such as Paraguay and Bolivia. Analytical methods that use the concept of miniaturization, green chemistry, and the adoption of acceptance methods are frequent in most articles. Chemometric and statistical tools are widely used for the analysis, development, and conclusion of identification and quantification methods. In general, the most used analytical technique is LC-MS/TS, but other techniques have gained ground for the analysis of illicit drugs, such as GC-MS associated with sample preparation and analysis techniques like SPE, TV-LVI, LDI, MALDI, and FTIR, among others. Furthermore, the data show that the consumption of illicit drugs is increasing in Brazil, especially among young people. Thus, there is an urgent need to monitor the levels of illicit drugs in water bodies in different regions of the country to assess epidemiology and environmental contamination and gather indicators for social policies that curb the consumption of these drugs in the Brazilian population.