Although the rate of drug use for most psychotropic substances has declined over the past 2 decades, the prevalence of drug use among adolescents continues to be a serious problem. Furthermore, there has been little change in the reported use of alcohol among teenagers. Drug and alcohol abuse are a major factor in the deterioration of the health status of this population due to accidents, homicide, and suicide. Some of the theories of drug use causation in adolescents focus on problem behavior, social learning, biopsychosocial, and social stress models. A number of genetic and family factors put youth in high-risk categories as do peer-related, psychological, biological, environmental, and demographic factors. The author notes the need for a more clearly defined role of health care providers in the prevention, early identification, and treatment of adolescents who abuse alcohol and other drugs. 84 references