Information was gathered formally during 1984 and 1985 and informally until the spring of 1987. The researcher observed and took part informally in local community life, used a snowball technique to observe and discuss drug use with heroin users, and conducted structured interviews with 20 heroin addicts. Findings indicated that extensive heroin use is likely to remain a major problem in the near future because of the role it has come to play in the local youth subculture and the criminality of the local culture that facilitates long-term use. In addition, treatment services have responded to community interests and demands, but it is too early to determine how far the effort to consider chemical dependency more than a medical problem will go. Finally, the degree to which the hospital-based drug treatment units can accommodate community interests and demands will determine their future and that of the medicalization of the drug field.