The aim of this paper is to review policy and practice in relation to the management of alcohol and drug problems in Ireland, with a specific focus on the role of professional social work. There is a high prevalence of alcohol and drug problems in the caseloads of social workers that work within the statutory childcare and criminal justice services. Professional social work in Ireland is of comparatively recent origin and there are few social workers employed in specialist addiction posts or settings in Ireland. The profession as a whole, moreover, has not actively lobbied for a greater role in specialist services. While formal social policy on addictions has shifted in recent decades towards broad public health strategies, which reflect a pragmatic European perspective, the disease model from the United States of America continues to have popular appeal.