Current German drug policy generally follows the principles that supply reduction efforts should focus on criminal justice responses, while demand reduction efforts should encourage “therapy instead of punishment” whenever possible. However, compliance with treatment may be compelled by threat of punishment. The historical context in which German drug policy evolved is reviewed, followed by a discussion of the emergence of harm reduction policies in general. German drug policy has evolved in a series of stages that follow three distinct policy paradigms: (1) criminalization; (2) medicalization; and (3) acceptance. The author illustrates the way in which German drug policy has progressed through each paradigm to arrive at the current acceptance paradigm in which the decision to ingest potentially harmful substances is left to the self-responsible user. Under the acceptance paradigm, regulation of substance abuse is limited to drug prevention and education, consumer protection, and health measures. Several convergent aspects of social change in Germany supported the shift to the “acceptance” paradigm; these six major areas of social change are enumerated and include the development of scientific and professional standards and need for Germany to economize. Changes in drug laws and drug law implementation among European Union Member States are reviewed and legislative developments in the medicalization of the drug problem are examined. The author argues that elements of all three drug policy paradigms have been variously integrated into German policies and strategies. Notes, references