The five major recreational drugs in the United States are tobacco (when smoked in cigarettes), alcohol, heroin, cocaine, and marijuana. Data indicate that for the population as a whole, the health problems caused by the currently legal recreational drugs are far more serious than those caused by the currently illegal recreational drugs. Because of the criminal nature of the cocaine market, this drug exacts the highest economic cost of any of the recreational drugs, followed in order by alcohol and cigarette smoking. The legal status of the primary recreational drugs has been determined chiefly by economic, political, and moral considerations. Logic, biomedical and epidemiological knowledge, and social and economic costs have had a small role in policymaking. Given that the violation of motor vehicle statutes is a crime, alcohol abuse poses the most serious drug crime problem, followed by heroin and cocaine. The legalization of currently illegal drugs would deal only with the crime problem, not with the problems posed by drug abuse. Dealing with the causes of drug abuse requires a multifacted program that includes the replacement of the drug culture with a health culture; restrictions on the supply, distribution, and availability of drugs; the price structure for legal drugs; tax policy; educational programs; and the provision of economic opportunities for those affected by the economic decline occasioned by the reduced use of drugs. Opponents of such a program are powerful, and the chance of its being strongly implemented are currently slim. 31 references.