About one-fourth of child abuse cases involve adolescent abuse, which is strongly linked to drug abuse. Factors related to this abuse include blurred generational boundaries, disintegrating marriages, reduced sex in the marriage, inhibition of normal anxiety, distorted emotional expression, denial and secrecy, rigid roles, disturbed sibling relationships, and other characteristics. Primary care for adolescents seeks to prevent abuse through outpatient efforts. Secondary treatment emphasizes a mental health concept of the adolescent's problem. Tertiary care involves inpatient treatment and assumes a high level of disability due to multiple problems for the adolescent. Case examples of adolescents who are children of alcoholics and abusers and who themselves may abuse drugs reveal the treatment issues involved. In addition, two prevention programs operating in New Jersey and Texas provide family therapy or comprehensive school-based treatment and represent possible interventions to teach successful intergenerational relationships and prevent abuse. 35 references