Although criminal laws make these distinctions, our approach to the problem has not always done so. Incapacitation, prevention, punishment, control, and treatment individually and collectively have not worked. Our approach to drug use has been costly and without any real sense of humanity or respect for the rights of the individual. Our criminal justice agencies are overloaded and perhaps at the brink of collapse. Along with decriminalization, a return of the problem of drug abuse to medical control, similar to that practiced in Great Britain, should at least receive serious consideration. Research and evaluation studies should be part of this effort. The existing research shows a strong statistical relationship between drug use and crime, but the nature of the relationship is unclear, and causality has not been proved. Drug users, especially heroin addicts, commit large numbers of income-generating crime, but much of the crime problem is a product of our own misguided public policy. The conflict between moralists and libertarians has confounded rather than helped us resolve the dilemma of what to do with those who insist on hurting themselves. All agree that predatory crimes should remain criminal offenses, but changes in laws regarding possession and use might significantly reduce such crime. A discussion of the historical background of drug control in the United States and of programs in Great Britain and the United States is included. Seventy-four references are listed.