The development of the disease concept of drug use and the application of the medical model of management of drug problems were an accompaniment of the growth of modern medicine. They have, however, been subject to considerable review and criticism. A positive response to such criticism is advocated. Consideration of the ‘way of life leading to predicaments’ model, based on the work of a number of authors, allows the identification of essential tasks in helping people out of predicaments and the clarification of roles that psychiatrists can and should play.
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