Results show public health risks faced by adolescents are the same as those associated with adult users with addictions to an opiate. These health risks include: exposure to infectious diseases in the short term; and the possibility of scarred or collapsed veins, endocarditis, and liver and kidney disease in the long term. Findings suggest that effective prevention programs need to target adolescents before the age of 14 which is the most likely age for initiation of heroin use. Cognitive behavioral therapy and opioid maintenance therapy may also be appropriate for adolescent clients who are at least 16 years old and have parental consent. Experts in opioid addiction also believe that buprenorphine should be the treatment of choice for adolescent patients since they generally have only short term addiction histories. Finally, all treatment programs for adolescents should be reexamined for effectiveness and redesigned accordingly, such as providing for additional relapse and recovery services that are age appropriate to promote and sustain recovery for adolescent users. Data were collected from 1,600 adolescent heroin abusers using the 2007 Treatment Episode Data Set (TEDS). Table, figures, and endnotes