As A society, we spend vast amounts on mopping up the effects of alcohol and drug abuse before beginning to tackle the difficult question of how to prevent further harm.

As A society, we spend vast amounts on mopping up the effects of alcohol and drug abuse before beginning to tackle the difficult question of how to prevent further harm. Increases in hospital admissions owing to alcohol and the number of people sent to prison for short sentences as a result of a drug habit show how entrenched the problems have become. In its quest to find ways of halving the harm from substance abuse by 2025, Scotland's Futures Forum has discovered that effective solutions are likely to be radical.

Retaining a proportion of the tax take on alcohol to provide treatment for problem drinkers is one of the suggestions it makes. Tax strategy is, of course, a UK matter, but the Chancellor, in creating an escalator that will see the tax take on alcohol rise above inflation over the next five years, has already made a fiscal acknowledgment of the problems caused by the relatively low price of drink.

The sale of cheap alcohol in supermarkets has been widely criticised as encouraging binge drinking. If increasing the tax could both raise the price (although there is a problem in setting a minimum price) and raise money for the treatment of problem drinkers, it would have the additional merit of acting as a reminder that alcohol misuse has costs for the NHS and for criminal justice.

That would allow better follow-up to new strategies, such as identifying problem drinkers who are admitted to A&E for more than one alcohol-related incident. The bald statistics on alcohol are frightening. Between 1996 and 2004, the rate of women with alcoholic liver disease rose by 81%, while those with chronic liver disease rose by 92% for men and 100% for women. Yet there is no systematic and effective treatment for Scotland's 150,000 "hazardous drinkers", only about 5% of whom are in touch with services.

That compares with more than 40% of heroin addicts in Scotland, although there are three times as many problem drinkers as problem opiate users. One reason for the difference is that interventions such as methadone are employed to reduce crime committed by addicts to fund their habit. The report takes this a step further in suggesting providing safe places for drug users to inject or allowing heroin to be prescribed to addicts. However, these have the same advantages and disadvantages as methadone: they cut the health risks but do nothing to tackle the underlying problem of addiction.

Too often social policy is made with one eye on how it will play with party politics. As a non-political think-tank of the Scottish Parliament, Scotland's Futures Forum has not eschewed controversy. Its quest for strategies that have been found to be effective elsewhere has produced some bold suggestions. They will not all be applicable in Scotland, but if we are to halt the blight wrought by both alcohol and drugs, we must be much more radical. Well-targeted, carefully-monitored pilot schemes should be part of any serious attempt to change the dependency culture.