Opiate addiction has a long history in the United States. The 500,000 heroin addicts who are currently concentrated in metropolitan areas constitute a major social problem for the nation, because of their self-destructive lifestyle and their antisocial behavior. Major findings regarding heroin addiction are that it has many causes, that no single approach or institution can solve the problem, and that ambivalent attitudes exist regarding treatment of drug abuse. All major treatment approaches for heroin addiction are successful for some patients, and most addicts who enter methadone maintenance programs improve. However, current evidence does not support a policy of compelling hardcore criminal addicts to attend existing methadone maintenance programs, because the chance for positive change is minimal and the probability of program disruption is high. In addition, current programs lack the staff and program resources to establish and maintain viable links between treatment programs and the criminal justice system. Table and 26 references.