The ECDD first met in 1949, and since then has reviewed over 450 substances up to the present day. A proportion of the 450 substances are around 100 substances considered between 2014-2023 which are of current public health relevance. In recent years, the WHO ECDD has advised the CND on the international control status of a number of important substances such as cannabis, which resulted in its reclassification for consideration for recognized therapeutic uses. In addition, other notable reviews from recent years include kratom, tramadol and ketamine. Further information on substances reviewed by the ECDD can be found at the ECDD Repository.

In January 2010, the Executive Board of the WHO adopted a revision of the Guidelines for The WHO Review of Psychoactive Substances for International Control. These Guidelines govern the evaluation of substances for WHO's recommendations to the Commission on Narcotic Drugs (CND) as required by the Single Convention on Narcotic Drugs, 1961, and the Convention on Psychotropic Substances, 1971. The WHO is the specialized agency of the United Nations that conducts the medical, scientific and public health evaluation of psychoactive substances under the Single Convention on Narcotic Drugs, 1961 (the 1961 Convention), as amended by the 1972 Protocol, and the Convention on Psychotropic Substances, 1971 (the 1971 Convention).

WHO first developed the guidelines document for the evaluation and assessment of narcotic and psychotropic substances for decisions on international control in consultation with CND in 1986, which was revised in 1990. Amendments and decisions subsequently adopted by the Executive Board in 1994 and 1999 resulted in a further revision in 2000. Subsequently, at the request of the Expert Committee on Drug Dependence (Expert Committee), supplementary guidelines were submitted to the Executive Board in order to clarify certain issues. The Board considered the proposed supplementary guidelines in May 2004 and January 2005. The 2010 revision of the guidelines was prepared in response to that request.