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The origins, vicissitudes and limitations of the disease concept amd medical model of drug use are examined. It is proposed that the disease concept is a reaction to the moralism or neglect of previous times. However the concept omits the human element. ‘Way of life’—a model taking into account the interaction between drug, person and environment—is proposed, drug dependence being present when drug use, as a way of life, is given a high priority. Persons with drug dependence may find themselves in a ‘predicament’ and may need help to get their ways of life in balance again. Various implications of this proposed model are explored.

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This paper questions the adequacy of traditional models of human behaviour, including models of functional mental illness. It is proposed that random (chance) variation is an invariable rule of nature which must apply to neurophysiological processes. Because of this, internal chance (random variation in neurophysiological processes) must be an important factor in determining the course and onset of mental illness. It is proposed that external chance--fortuitous changes in the complex pattern of interaction between physical and functional factors influencing behaviour--is also an important determinant of mental illness. It is proposed that many of the key characteristics of mental illness are explicable in terms of the properties of complex interactional systems.