Achieving the long-term aim of reducing drug-related harms will only be possible if departments work collaboratively and adapt their approach to the evolving threats. The government has created new national and local structures to enable a co-ordinated response to implementing the strategy and tackling the harms caused by illegal drugs. We welcome these positive steps, and the progress made in recruiting 1,200 new alcohol and drug workers and the 15% increase in the closure of county lines. The JCDU has a key role to play in providing strategic leadership, disseminating good practices and holding departments to account for progress against the strategy’s intended outcomes. But departments have mainly used funding to maintain or expand existing activities and, so far, this has not led to a fundamental shift in the approach to tackling illegal drugs. Dame Carol Black called for ‘whole-system change’ but expert witnesses consider that the strategy has not yet led to a joined-up cross-sector response to help people recover from addiction. The JCDU and departments have not yet established how the existing approach needs to change to achieve long-term aims. They also need to be aware of emerging trends in illegal drugs markets and adapt their approaches to new threats, such as synthetic opioids which are increasingly emerging as a problem in the UK. 1 Q93 6 Reducing the harm from illegal drugs Recommendation 2: The JCDU and departments should assess how the next phase of the strategy can build on progress in the first three years and embed a system- level focus on the difficult issues involved in tackling drug-related harms. In doing so, they will need to address structural barriers (e.g., to recovery and continuity of care), take account of changing threats and set clear accountabilities for delivery.