In 1998, a licensing system for the prescription of methadone by general medical practitioners was created in the hopes of expanding the number of drug users in treatment and reducing the availability of the drug on the black market. This article examines the policy process that succeeded in introducing radical change in a relatively conservative drug treatment system while avoiding any major public dispute. The research methods used were documentary analysis and informal discussion with policy makers known to the researcher. The key stakeholders in the policy process were the National Drug Advisory and Treatment Centre/Trinity Court, the Eastern Health Board (EHB), general practitioners (GPs), pharmacists, the voluntary drug treatment sector, the Department of Health, national politicians, and the Irish public. The policy process that resulted in the introduction of the methadone protocol in 1998 was generally low key and incremental. It began in 1990 when the Irish College of General Practitioners produced a policy statement on the management of problem drug users in general practice. This statement affirmed that clinical work with drug users was a legitimate function of general medical practice. In 1992, the Minister for Health appointed a committee designated The Expert Group on the Establishment of a Protocol for the Prescribing of Methadone. The Expert Group was asked to consider three issues: methadone prescribing, registration of drug users, and licensing of GPs to treat drug users. The subsequent report recommended that GPs that prescribed substitute drugs for opiate-dependent patients should do so only with the support of specialist services. In 1996, a pilot methadone project was set up in the EHB region. Later that year the proposal to expand GP involvement in methadone prescribing received public support from a committee of junior ministers. It seems fair to conclude that drugs policy making in Ireland is characterized by pragmatism, in terms of harm reduction content and its covert process. 1 table, 33 references