Recent national surveys indicate that, among teenagers, the use of many illicit drugs has declined significantly from the peak levels attained during the 1970's, with cocaine abuse being the exception to this trend. Alcohol and drug use are still prevalent among adolescents, however. The consequences of alcohol and drug use include long-term physical, psychological, and social consequences. Most often, the diagnosis of drug abuse is made on the basis of behavioral or physical changes that indicate the possibility of underlying drug use. In each of the four basic stages of the drug dependence syndrome, the pattern of drug use and the progression of signs and symptoms resulting from drug use are observable. Youth with low self-esteem, inadequate interpersonal skills, negative peer relationships, and impaired family relationships may be at increased risk for drug use. Through proper assessment and treatment, psychiatrists can play an important role in the prevention and early intervention of substance abuse problems. 14 references.