The term ‘evidence based’ has become something of a buzz word in alcohol treatment services internationally. In this chapter we deconstruct what ‘evidence-based’ means - what constitutes as evidence and how it relates to practice. We examine the evidence base through the lens of different perspectives: the individual with alcohol difficulties; their family members or concerned others; treatment providers; those who commission services and academics involved in the generation of evidence. We think about practice based evidence and how this may manifest and influence practice. We conclude by looking at the themes conveyed from each of the perspectives; the reduction in time and resources available, social stigma, and the subjectivity or interpretation of the guidance. Recommendations are made, that bottom up co-production of services, longer commissioning cycles, values based staff recruitment and the integration of ‘evidence based practice’ with ‘practice based evidence’ are ways to affect real change and improve service provision.
