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Milkman and Frosch describe the similarities and the differences in two groups of drug abusers. Such factors as an underlying sense of low self-esteem, feelings of helplessness in the face of a threatening environment, and regression to states recapturing phases of early childhood development appear characteristic of most drug abusers. Within this context, however, the heroin abuser was observed to consciously view himself with contempt, to be subject to depression and despair, to markedly limit his aspirations, to maintain equilibrium through withdrawal, and to avoid confrontation with his surroundings. The amphetamine abuser appeared to utilize a different set of defensive reactions; denial, projection, rationalization, and intellectualization were characteristic. Equilibrium was maintained with great expenditures of psychic and physical energy. The amphetamine user presented a consciously inflated sense of self-worth and actively confronted his environment. The authors found it difficult to determine whether these findings represent a factor in the etiology of the pattern of drug abuse or the result of such drug use and its imposed life pattern.