Responses to drug-related problems in Wales began with the first National Health Service in-patient admissions in the late 1960s and extend to the present, including the May 1996 publication of Forward Together, the Welsh Office strategy for drug and alcohol problems. The article places service developments in the context of available data about the nature and extent of drug use throughout Wales, the particular challenges, and strategies adopted in Britain and Wales and at the local level. Understanding drug misuse within a society and the response in the form of services involves consideration of such issues as public perception, central government policy and funding, availability of drugs, prevailing drug use patterns, changing opinions about different types of drug services, and local cultural factors. The article discusses how these factors influence drug trends in Wales. The paper was written during a time of unprecedented upheaval in the purchasing and coordination of all public services in Wales and when continuous downward pressure on public spending meant there could be only very limited service development. Growing numbers of individuals and communities facing drug problems, major organizational changes, and decreasing government investment suggest difficult times ahead for drug services in Wales. Figure, tables, references