This monograph adds a new dimension to traditional punishment-treatment concepts by assigning responsibility for criminal behavior and by requiring active, rather than passive, reparative efforts. Under this perspective, the juvenile justice system would provide the monitoring and support services necessary to ensure that offenders are held accountable. This study included a national needs assessment that provided information on juvenile courts' response to juvenile drug offenders, the impact of drug offenders in corrections and community supervision programs, and gaps that exist in sanctions and supervision. The juvenile justice practitioners surveyed were enthusiastic about the concept of an accountability approach for drug offenders. In accordance with an accountability approach for juvenile drug offenders, the survey yielded strong support for the following sanctions: confiscation of any proceeds from drug sales, direct restitution payments to victims of drug sales, restitution payments into funds to support drug treatment, community work/service in public agencies, and intensive work crews. A pilot project design is suggested along with resources for accountability programming and practice, technical/training assistance, and program funding.