The literature identifies factors in the family environment associated with juvenile alcohol abuse, notably the family's rejection of the adolescent, the adolescent's rejection of the family, the lack of controls experienced by the adolescent, family attitudes and behavior concerning alcohol use, and a high degree of family tension or anxiety. The pathology of adolescent alcohol misuse is a reaction to these familial influences, and the particular response of alcohol abuse apparently results from the juvenile's need to distance himself from the family. Adolescent alcohol misusers, however, do not leave the family system, as is the case with adult alcohol abusers. They remain as active participants in the family. This continuation within the family perpetuates interactional patterns that maintain the symptomatic behavior. 36 references.