Compared to other Western democratic societies, the United States’ response to drug-taking has been demonstrably enforcement-oriented, relying on the criminal justice system to control distribution and use through the tactics of deterrence and punishment. However, policymakers have begun to search for alternatives to traditional punishment/deterrence-based methods with which to understand and confront drug-taking behavior. Recently, the medical model of substance use has resurfaced. In this paradigm, consumers are diseased, sick, and in need of treatment rather than subjected to wholesale punishment. With this change, drug offenders are increasingly diverted to behavioral and psychopharmacological therapy in lieu of more punitive dispositions. In proposing an alternative strategy, this article first conducts a summary critique of compulsory substance use treatment. Observations describe the underlying rationale of diversionary initiatives. Second, the theoretical dimensions of a replacement schema regarding drug use and abuse are described and include an understanding of self-organization and natural recovery as mechanisms that advance desistance both in policy and practice. Third, the implications stemming from this more conceptual analysis are outlined which comprises a reconsideration of drug-taking activity and drug treatment programming consistent with the aim of promoting harm reduction. Notes, references