Ever since Friedrich Sertürner synthesized morphine out of opium in 1803, people have been self-medicating with synthetic derivatives of the opium poppy. Local epidemics of opiate and opioid addiction have occurred across the globe since the first Anglo-Chinese opium war (1839-1842). In the mid 20th century, global demand for diamorphine (heroin) created vast drug producing regions, such as The Golden Triangle (in South East Asia) and The Golden Crescent (in the Middle East). In the 21st century, big pharma has unleashed an epidemic of addiction to opioid analgesics. Treatment providers now face a serious challenge. How do they maintain abstinence as the ideal goal for opioid addicts, when risk of relapse and death by overdose upon discharge is so high? This presentation will outline a simple model which challenges what ‘clean’ really means, and manages tapered withdrawal within the context of a 12 Step abstinence model.