Drug misuse and addiction are inextricably linked to deprivation and poverty. Heroin addiction affects around 1% of adults in inner cities. This chapter describes a new primary care-based intermediate level service. The Primary care clinic for Drug dependence in Sheffield and the associated pharmacy scheme are now well established within the city. Drug users accessing treatment were confined to those prioritised, for example because of pregnancy or willingness to accept a short-term treatment such as Iofexidine detoxification. Harm minimization focuses on reducing the risk of drug misuse to the individual and to society. The rationale is the chronic relapsing nature of heroin addiction, which means that total abstinence for long-term users is often hard to achieve. A further role was to contribute to the development of training for general practitioners and other health service professionals and to contribute to further development of primary care treatment of drug users in the city.