This work examines the social, political and health policy contexts within which alcohol treatment policy has emerged and changed since 1950. Three themes are highlighted as particularly relevant to an examination of policy trends: The emergence and evolution of a “policy community” spear-headed by psychiatrists in the 1960s but broadening to include other profession and the voluntary sector by the 1980s. Betsy Thom’s text traces professional changes and tensions and their effects on the formation and implementation of policy into the ’90s. The role of research which influenced the nature and direction of policy. Changing approaches to alcohol treatment reveal the increasing uses of research as the rationale for social and health policy decisions and illustrate the move towards a contractor relationship between research workers and policy makers. The changing conceptions and competing paradigms of the problem tracing the effect of ideological shifts on the balance between treatment responses and prevention and public health approaches to complex social medical problems such as alcoholism. Within these broad themes, the text portrays the pressures and tensions on government departments, the efforts to secure consensus in the formulation and implementation of policy and the importance of understanding the historical-social contexts from which policy emerges.