Abstract
The concept that drug dependence is a disease has made treatment of persons with drug-related problems an acceptable option. However it is contended that the primary element of drug dependence is the allocation of a high priority to behaviour associated with drug use, that in any individual this level of priority changes over time and that these changes are influenced by many factors. Uncritical acceptance of some of the implications of the disease concept have contributed to unnecessary community anxiety, the adoption of repressive measures aimed at containing a supposed ‘epidemic”, inappropriate responses to drug users, and the growth of a special drug treatment industry. At the same time more widespread behavioural disturbances in the community have been neglected. It is suggested that community policies and priorities need to be reassessed.