Two opposing policy options shape the current debate on how to deal with drug use problems: (1) prohibition, supports widening interdiction, treatment, and prevention efforts while keeping drugs such as marijuana, cocaine, LSD, and heroin illegal; and (2) legalization, supports eliminating restrictive drug policies while limiting the harm associated with the nonmedical use of drugs. The drug legalization movement has gained modest public support in recent years by attempting to associate opponents of drug legalization with negative public perceptions about alcohol prohibition and by referring to opponents of drug legalization as prohibitionists. Drug legalization is a complicated policy option, particularly with respect to addiction issues, drug offenses, health and social costs of drug use, and drug use among adolescents. Although reducing the harm caused by drug use is a universal goal of all drug policies, current harm reduction proposals for drugs other than tobacco and alcohol focus heavily on reducing or eliminating criminal penalties for drug offenses, softer sentencing guidelines, drug addict maintenance programs, needle exchange programs for intravenous drug users, and the removal of work-place drug testing programs. The efficacy of these harm reduction proposals has not been established, and cost data indicate restrictive drug policies shift the burden from health and productivity sectors to the criminal justice system. Two drug policy models are described for evaluating the range of options available within drug legalization and drug prohibition policies. The authors that believe restrictive drug policies should not be dismantled and that the focus of drug control should be on harm reduction. 32 references and 4 tables