Results show that only half (51 percent) of the youths and young adults had ever participated in some form of addiction treatment. These results are consistent with the chronic nature of substance abuse. Little information is available about continuous abstinence rates among this population; the majority of substance abusers relapse within a year post-treatment. In spite of the resources available, many street-involved youths and young adults did not or were not able to access alcohol or drug treatment. Noted is that the majority of youths who had ever used crack, cocaine, heroin, or crystal methamphetamine had participated in some form of addiction treatment. Furthermore, access to treatment was independently associated with crack use, cocaine use, and injection drug use, even after adjusting for socio-demographic factors, such as age and education. Results suggest an urgent need for increased programs to educate youths and young adults about the risks of injection drug use. The relatively young age at which participants initiated drug use indicated that by the age of 22, the majority of students had been using drugs, such as marijuana for 10 years. Since serious consequences of overdose, incarceration, and mental health problems may result from long-term drug use among youths and young adults, it is recommended that evidence-based drug prevention programming for this population be developed, as well as increased street-based outreach. Data were collected from 478 participants in the At Risk Youth Study (ARYS) in Vancouver, Canada. Tables and references