The four communities represented the neighborhoods of approximately 85 percent of addict patients at the Manhattan State Hospital. Data showed that heroin users were actively engaged in meaningful activities and relationships. Much of the life of heroin users on the street centered around economic institutions of heroin distribution. Because of the high cost and poor quality of heroin, street users had to be totally involved in an economic career. Heroin use by lower class, primarily minority group persons did not give them a euphoric escape from psychological and social problems associated with ghetto life. Rather, heroin use provided a motivation and rationale for the pursuit of meaningful life, albeit a deviant one. A historical review of heroin use in New York City shows that heroin use patterns have changed at a pace and in a direction corresponding to social changes. The heroin marketing and supply process and typical economic careers of heroin users are described. 8 references and 1 table