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Substance use and misuse remain a feature of everyday life in the UK today. It is a cause of death and disability and a marker of deprivation and inequality. The health, social and criminal justice systems currently in place are not able to provide the flexible response in which the public can have confidence and to which they can adhere. While much of the debate has centred on younger people, including children and adolescents, attention has recently turned to older people who are misusing cannabis and heroin as well as over-the-counter and medically prescribed medications. The remarkable contributions of neuroscience over the half-century of 1960–2010 have demonstrated the biological basis of substance misuse, which can become a chronic medical condition, much like diabetes and hypertension. There is exciting potential for the development of new pharmaceutical agents for the treatment of substance misuse. An aspiration we have is towards a new public understanding of addiction through education so that people can make informed choices based on realistic policies.
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