In comparing and contrasting British and American orientations toward substance use and substance abusers, emphasis is on social change, social definitions of crisis, and trends in addictions treatment. A history of the harm reduction model (a model that helps clients control their drinking and drug use) is presented against the backdrop of the American traditional disease model of addiction. As used in this paper, "harm induction" refers to a war on drugs that has become a war on people, a policy that promotes criminalization instead of the treatment of persons with addictive problems. The author examines treatment modalities, with attention to motivational enhancement therapy, a therapy introduced by American academics and further developed by British academics and practitioners and now being reintroduced to the United States, especially in schools of social work. The paper considers whether the harm reduction model would be successful in the United States, its advantages and drawbacks, and its effect on the disease concept of addiction. Also discussed are funding sources and implications for social work education and graduates in the field. Arguments are informed by an international exchange program between U.S. midwestern and British social work departments. 28 references