The climate of domestic drug policy in the United States as it pertains to both women and men at the beginning of the 21st century is the criminalization mode of regulation--a mode that is based on the model of addiction as a crime and one that is used to prohibit the use of illegal drugs. In Canada, drug policy is based mainly on the harm reduction model, a policy or program directed towards decreasing the adverse health, social, and economic consequences of drug abuse without requiring abstinence from such use. Using a comparative perspective, several issues are examined in this article: the prevalence of substance abuse between the two countries, the significance of gender and substance abuse, drug costs relative to both countries, the prevalence of crime and substance abuse, and domestic drug control policies.