Heroin addiction is increasingly being recognized as a chronic relapsing condition, but relatively little is known about long-term recovery processes among addicts who attain and maintain long periods of abstinence. This study is to identify predictors of long-term stable recovery from heroin addiction based on 242 heroin addicts that have been followed for more than 30 years. Results showed that recovery and non-recovery groups did not differ in deviant behaviors and family/school problems in their earlier lives. Both groups tried formal treatment and self-directed recovery ("self-treatment"), often many times. While the non-recovered addicts were significantly more likely to use substances in coping with stressful conditions, to have spouses who also abused drugs, and to lack non-drug-using social support, stable recovery ten years later was predicted only by ethnicity, self-efficacy, and psychological distress. These findings suggest that in addition to early intervention to curtail heroin addiction, increasing self-efficacy and addressing psychological problems are likely to enhance the odds of maintaining long-term stable recovery.