Under this model, drug addiction is seen as a linear progression from heroin dependence to criminality, prison, and death; drug users have deficient personalities and lack individual responsibility and self-determination. This paradigm of drug treatment has led to high numbers of drug- related deaths and an erosion of the principle of voluntary treatment. Current research on the causes and effects of drug addiction have rejected the premises upon which the German system is based: the linear model of addiction is no longer considered valid, no single cause of drug addiction can be identified, drug use is not in itself a disease, and a one- dimensional drug treatment system cannot meet the needs of most abusers. The narrow range of abstinence programs, the emergence of AIDS-related drug problems, and increasing addict criminality and mortality rates all indicate the need for alternative concepts of drug aid work. The debate over the direction a new approach should take is being waged by supporters of traditional drug work, which strives for absolute abstinence, and supporters of "accepting" drug work, in which the primary objective is reducing the risks associated with drug use. 14 references