Pharmacological treatments are commonly used and necessary in treating many aspects of substance dependence from substitution, to detox and through to relapse prevention. However their efficacy is not always as great as either the individual or their clinician would wish for. Recent advances in understanding more about the neurobiology of substance use, abuse and dependence is leading to novel avenues for pharmacotherapy as well as understanding more about what contributes to efficacy. For instance, in relapse prevention new avenues including moving away from directly modulating the dopaminergic mesolimbic ‘reward/motivation’ pathway to targeting other neurotransmitter systems that alter activity in this system. In alcohol detox, there are good preclinical models which suggest ways forward to provide greater protection to the brain during this toxic time. As the role of memory in substance misuse becomes clearer, potential neuropharmacological targets are realised. This talk will use examples of the exciting developments in neurobiology to describe the future of pharmacological treatments.