This paper is an exploration of the issues which arise when developing a model of shared care for substance misusers in primary care. A rural primary care group (PCG) developed a shared care nurse (SCN) role to provide improved care for substance misusing clients, and to support professionals in both primary and specialist care. The SCN was employed by the specialist drug service (SDS) and, for the purposes of the pilot project, the SCN held clinics at three general practitioner (GP) practices. An evaluation of this pilot project forms the basis of this paper. Semi-structured interviews were undertaken with clients of the shared care service and with professionals involved in the treatment Of substance misusing clients. These interviews were recorded, transcribed and then analysed for salient themes. Questionnaires were distributed to members of the primary health care teams who had not been interviewed, and responses were also thematically analysed. This paper highlights the benefits and barriers encountered in developing a new model of care for substance misusing clients. It clearly illustrates improved satisfaction with service provision, both for service providers and clients. There continued to be difficulties, however, with waiting lists and clear referral pathways for the treatment of substance dependency.