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In this paper existing approaches to the conceptualisation of drug use by youth (according to the Australian Bureau of Statistics category, ‘youth means those aged between 15 and 24 years) are critically examined and some comments on the nature of prevention programmes are presented. It is contended that, given the universality of drug use in human societies and the very real benefits that accrue from drug use, the usual prevention goal of abstinence from drug use for young people is unthinking, unobtainable, and unacceptable. Those involved in the future formulation of research projects, prevention programmes and policy in the area of young people’s drug use need to embrace a low-risk use or a harm-minimisation paradigm. Unless such a perspective is adopted the current failure to record much in the way of success in the prevention of drug-related problems amongst young people will continue. In essence, there needs to be a wider acceptance amongst those working in the prevention field of the notion that drug use has value, is here to stay and that we must learn to live with drug use as best we can. The implicit, but almost pervasive, notion that drug use per se is something which can, and must, be prevented needs to be accepted for what it is - a chimera.