This paper aims to reflect on research findings from different empirical studies of social work with young drug users and socially excluded young people in Copenhagen. In the paper we account for historical changes in social policy and interventions into young people's drug taking in Copenhagen, and we discuss some of the most central dilemmas in today's social work with young drug users. Among other things, we identify pervasive marginalizing dynamics in the social system that result partly from the deep-rooted cultural dichotomy between stigma and taboo that organizes the drug issue, and partly from the decentralizing and specializing efforts characteristic of the Danish welfare state and its institutions. We discuss a general turn towards street level interventions to address the problems of social exclusion, as well as different attempts to create what we term street level heterotopias - sites of alternate ordering - where issues of drug use and other social problems can be dealt with and objectified in more flexible ways and handled as part of ongoing social practices of everyday life.