A comprehensive approach to the treatment of drug-abusing and dependent persons is proposed based on a knowledge of the psychopathology and the psychodynamics of drug abuse and psychological dependence. The role of psychiatric understanding of drug dependence is historically developed. The recent contributions of clinicians and researchers evolving from psychoanalytic ego theory as well as psychopharmacological orientation are discussed. The authors argue that categorizing people in terms of overt behavior - drug abuse or dependence - is not sufficient. Specific psychopathological and/or psychodynamic conditions should be diagnosed and utilized as the basis for treatment.