Direct practice social workers have potentially significant policymaking opportunities as mediators of top-down policy and as creators of policy where none exists. The power they possess stems from their ‘on the ground’ expertise and the discretion available to them in making practice decisions. By understanding their power as “street-level bureaucrats” they can significantly improve policy. Drawing on policy issues in mental health and addictions services, this article illustrates how social workers can use their power in an ethically sensitive manner to enhance policy outcomes for clients.