Beyond Vancouver's “Four Pillars”

This article first describes Vancouver's “Four-Pillar Approach” to the problem of drug misuse. Then, a historical analysis of addiction in free-market society is undertaken. On the basis of this analysis, a recently proposed reconceptualisation of the Four-Pillar Approach is endorsed and three suggestions for additional steps, beyond the domain of the Four-Pillar Approach, are described. I argue that many such steps, far beyond the Four-Pillar Approach, will be necessary if the devastating problem of addiction is ever to be brought under control.