Behavioral health and social service needs are common in most arrest populations. For most individuals, these needs will not interfere with making court appearances and remaining arrest-free before trial. However, need can escalate into a heightened risk of pretrial misconduct for some people. This publication discusses the complexity of managing substance use disorder—a prevalent need in most arrest populations—and suggests a “pretrial intervention services” model that outlines when pretrial agencies should consider services, when services should be integrated into supervision support, and what treatment service strategies are best at the pretrial stage.