The perspectives of analysts such as Abraham, Rado, Zimmel, Tibout, Wurmser, Khanzian, Krystal and McDougall are reviewed alongside original and more recent conceptualizations of drug addiction and recovery based on Kleinian, Winnicottian and Kohutian ideas. The case material deals with clinical phenomena that characterize working with this complex population, such as intense projective identification, countertransference difficulties and relapses. The theoretical analysis covers a range of concepts, such as John Steiner's psychic shelters and Betty Joseph's near-death-addiction, which are yet to be fully explored in the context of addiction. Prevalent topics in the addiction field, such as the reward system, the cycle of change and the 12-step program, are also discussed in relation to psychodynamic theory and practice. Written by an experienced therapist, is useful reading for anyone looking to understand how psychodynamic thought is applicable in the treatment of drug abuse and addiction. It may also be of some relevance to those working on treating alcohol use disorders and behavioral addictions.