The National Substance Misuse Conference 2018 explores issues facing clients; professionals and services. It provides an insight into current thinking and latest developments from a variety of perspectives: policy; practice and prevention. The conference draws together the UK’s leading clinicians; researchers; educators and many more to consider how we meet the challenge now and in the future. This is a time of great interest and change in the Substance Misuse Field; keeping Drugs & Alcohol on the political agenda will inevitably lead to many improvements on the ground. This conference is exactly the platform for these discussions to be highlighted.