Recent research into drug problems in a number of cultures and settings has indicated that a disproportionate amount of the harm and costs arising from drug use is associated with the relatively small proportion of dependent users, sometimes referred to as ‘problem drug users’ (PDUs).

With the increasing recognition of the scale of the problems associated with dependent drug use, and that these problems cannot simply be resolved by enforcement action against the target group, treatment for drug addiction has progressed in the last 20 years from being a marginal and poorly resourced activity to, in many countries, the central pillar of the national drug policy.

There is no doubt that the availability and accessibility of treatment has increased dramatically in recent years in many countries. However, there is a clear ‘treatment gap’ – between the numbers assessed as needing treatment, and the number of places available – in almost all countries, and there are many parts of the world where treatment services are non-existent, inaccessible to most users, or based on questionable methodologies.

So, what exactly is involved in the treatment of drug dependence, why is it so important in the reduction of drug problems, and how can it best be expanded and organised by administrations with limited capacity and resources?