Drug abuse begins in adolescent groups and peer-to-peer transmission is responsible for epidemics. This is most malignant when it appears in disadvantaged minority groups in the inner city. The cycle of improvement through treatment is followed by repeated relapse. Most psychiatrists are not prepared to understand that the positive image they enjoy in ordinary practice turns to a negative one in the drug world. Optimal contribution from psychiatrists are associated with team functioning with ex-addicts or paraprofessionals who serve as interpreters of the drug subculture and as primary counselors for patients in treatment. (63 pp.)