Drug abuse is a "disease of lifestyle" and each year thousands of adults and children die as a result of substance abuse. Children who live in homes where illegal drugs and alcohol are seriously misused are vulnerable for abuse and neglect. Emotional neglect is a major theme and most children exhibit both cognitive and interpersonal problems as well as other generalized psychiatric disturbances. One of the most tragic manifestations of the drug abuse problem are the many babies born addicted and/or infected with the AIDS virus from intravenous drug users. In addition to direct abusive acts on children, there is evidence of the recruiting of children as young as eight years of age to becoming "lookouts" and "runners" for drug dealers. Public policies at the Federal, State, and local levels are needed as guiding principles for public and private systems intervention. Prevention strategies which also deal with systematic changes in institutions such as schools, churches, governmental agencies, and business will provide the basis of support for children and families who are most at risk. 16 references.