Little information is available about effective treatment programs for adolescent substance abusers, despite well- documented evidence about the behavioral, physiological, and social consequences of alcohol and drug abuse. Adolescents' patterns and problems of substance abuse differ sufficiently from adults' to warrant different treatment approaches. Clinicians should be aware of the stages in the development of substance use as well as the cultural differences, so as to deter epidemic alcohol and drug abuse. Comprehensive, integrated, and systemic services must be available so that a specific treatment approach can be tailored to the needs of each youth. Interventions can be powerful and effective tools to motivate adolescents to enter treatment. Adolescents who require detoxification should be monitored by appropriately trained personnel under the direction of a physician with expertise in the management of addiction and withdrawal. In the treatment community, the goal of treatment is global change in the individual that includes the integration of conduct, feelings, values, and attitudes with a drug-free lifestyle. Aftercare, such as day treatment for the juveniles, is especially important. Staff and family members must be prepared to be mediators of treatment gains made by the treatment community. Treatment matching is a new concept of juvenile services, whereby clients are matched to specific types or intensities of treatment on the basis of particular characteristics and behaviors. Self-help approaches such as 12- step programs or family support meetings that are appropriate to the age, gender, and culture of an adolescent are useful as part of an inpatient, residential, or day-treatment program or as adjuncts to outpatient care. Relapse is common in recovery from substance addiction, and its prevention should be incorporated into treatment planning. 44 references