Legal and illegal drugs are responsible for 18 per cent of all years lost due to ill health and premature death in Europe, imposing economic burdens of 2.5 per cent of gross domestic product. No one country has yet got it right in terms of policies to reduce the harm done by drugs. This book, based on a five-year European reframing addictions project, proposes a nine-point plan to redesign addictions governance: (1) heavy use over time should be the replacement descriptor for concepts and terms such as dependence; (2) policies should address and reduce the social stigma linked to addictive drugs; (3) drug policies should be based on a sound understanding of evolutionary behaviour, with humans having evolved to be active and functional, rather than passive and vulnerable, with respect to drug-taking; (4) addiction policies should be assessed for their impact on a range of societal well-being outcomes beyond physical and mental health; (5) drug policies should be monitored by toxicology-based margins of exposure (MOE) analyses, with no policy resulting in a MOE of under 10 for individual daily drug consumption; (6) addiction policies should be judged for their impact in reducing heavy use; (7) smart addiction policies require whole-of-government and whole-of-society approaches; (8) government policy-making for addictive drugs and behaviours should be free of the influence of relevant producer and service provider companies; and (9) a health footprint should be used as the accountability tool to apportion the ill health and premature death due to drugs across both public and private sectors.