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The public debate on illegal drugs is dominated by a fascination with the substances themselves – how they are produced, smuggled and sold, what they do to us, and (interminably) what their legal status is or should be. However, with a full-blown review of the national drug strategy expected in the spring, the real issue is not how we deal with drugs, it is how we treat drug users.

Chronic drug misuse is primarily a health issue with its roots in social exclusion. It is a problem that can only be solved within a framework of health services. This means improved clinical treatment combined with ‘wrap-around’ social care to provide the conditions which enable treatment to be effective. Treatment and care should be supplied not simply through specialised ‘drugs services’ but also by creating easier access for drug users to mainstream provision.