Left Realists argue that criminology should be restructured to account for the views and experiences of inner city working class people for whom crime is a constant problem. Dorn and South assume three principal themes concerning heroin and heroin policy: Left Realist theory, the deficit model, and the policy of harm and use reduction. These principles lead to the conclusion that drug use is a negative pathology that can be solved through economic change. In political terms, they advocate policies that are electorally acceptable, but practically unrealistic. Their two mistakes are to assume that pursuit of drug use reduction can be advocated with a simultaneous check of economic growth, and that policies widely believed to work will actually work. The policy advocated in this article would consist of realistic harm minimization strategies similar to those applied to alcohol use and abuse. 26 references.