The harm-reduction strategy for countering the problems of drug abuse is based in a public health tradition. It reflects pragmatism, humanistic values, a broad focus, a balancing of costs/benefits, and a hierarchy of goals. The goals of harm reduction are to decrease adverse health consequences of drug use without requiring decreased drug use, decrease adverse social consequences of drug use without requiring decreased drug use, and decrease adverse economic consequences of drug use without requiring decreased drug use. Some programs that reflect a harm- reduction strategy are syringe exchange, methadone maintenance, education/outreach, alcohol programs, nicotine programs, prescription drugs, and tolerance areas. The authors present some examples of such programs in the Netherlands, South Australia, and England. The full embrace of harm-reduction initiatives may require, in the long run, the replacement of the dominance of the criminal justice model with explicit public health assumptions and supportive legal controls. There will always be a role for law enforcement in dealing with the broader issues of availability even in a more regulated market. A future goal should be to develop a new system that is consistent with current scientific knowledge and is able to incorporate new scientific findings for effective social control of drugs.