Opium addiction was prevalent in the United States from the early 1800s to the early 1900s, but after the Narcotic Act of 1914, it essentially disappeared from America until it reappeared among Indochinese refugees during the 1980s. Fifty opium addicts (49 Hmong and one Lao) who sought treatment at the University of Minnesota Hospital and Clinic are the subjects of this study. Findings confirm the predominant onset of opium addiction during the early phase of adult productivity, its morbid psychosocial consequences for the individual and the family, and its tendency to spread in epidemic fashion to younger people. Social consequences of opium smoking in the United States include development of a delinquent-criminal subgroup to supply opium to addicts, which has fragmented some expatriate refugee communities; the occurrence of gangland-style violence; and the beginning of poppy culture by Indochinese refugees in six American States. Tables, references