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Successful 'recovery' from long-term problem drug use has depended largely upon understanding and tackling the physiological and psychological nature of drug dependence; however, drawing upon research and practice in Liverpool, England, the author questions whether this discourse is sufficient given the changing nature, context and attitudes towards drug consumption in the twenty-first century. This article emphasises the importance of incorporating structural and social factors. Drawing upon qualitative data from three separate studies, the author illustrates how stigmatisation, marginalisation, and social exclusion are significant debilitating components that have tended to be overlooked. This paper contributes new insights into the damaging impact of political rhetoric and structural discrimination that has placed many long-term drug users vulnerable to relapse. In response to these findings the author offers a new conceptual framework for practice, that incorporates and promotes an understanding of the social nature and context of long-term drug dependence. [ABSTRACT FROM AUTHOR]