The causal nature of substance abuse must be identified in order to develop effective treatment paradigms; research must focus on the roles played by biological, cognitive, and learning variables. Reduction of substance abuse will be minimal until paradigms are developed for substance abuse among pregnant women, minorities, and adolescents. While research on the causes of adolescent substance abuse is increasing, there is still little known about effective prevention strategies; most programs still only focus on one of several variables including family, school, peers, and communities. Model programs have emphasized development of positive peer influence and improvement of parental communications and problem-solving skills. Effective educational programs aimed at substance abuse prevention conducted within the schools can negate the powerful influence of peers. Parent Effectiveness Training classes help parents learn how to set good examples, establish expectations on drug use, and enforce consequences. Television programs, celebrities, or the media could also exert a more powerful influence on adolescents. Community programs that have successfully formed coalitions have been able to change local norms of acceptance regarding substance abuse. Finally, business and industry have a role to play in substance abuse prevention by fostering positive attitudes through media advertisements. 1 table and 85 references