Juvenile courts handled three drug cases and three alcohol cases for every 1,000 youths between 10 and 17 years of age who lived in their jurisdictions. Juvenile courts in large counties handled higher rates of drug cases than small counties, while small counties handled higher rates of alcohol cases than large counties. More than half the youths referred to juvenile courts for drug or alcohol offenses had at least one prior referral to juvenile court. Alcohol cases were more likely than drug cases to be handled informally by juvenile courts. In those cases handled formally, 54 percent of youths charged with an alcohol offense and 70 percent of youths charged with a drug offense were placed on probation or in residential facilities. Drug possession and drug trafficking cases were equally likely to be handled formally by juvenile courts. Driving under the influence cases were more likely than other alcohol cases to be handled formally. The extent of drug use among youth in the United States is examined. 9 references, 1 table, and 8 figures