While there is some debate in the research literature concerning the causal nature of the relationship between juvenile delinquency and drug use, there is little question that many youths who commit delinquent acts also abuse drugs or alcohol. This chapter begins by examining the extent of drug use among adolescents in the United States using different data sources, such as the Monitoring the Future (MTF) Project and the National Survey on Drug Use and Health. Overall, data suggest that the drug abuse problem among adolescents has been exaggerated and that relatively few youths use drugs on a regular basis. The extent of drug use among the juvenile offender population is explored, which indicates that drug use among youthful offenders is significantly higher than among the general adolescent population. Next, the authors consider the possible factors influencing the relationship between drug use and delinquency, including causal and spurious factors. The authors note that no overwhelming consensus has been arrived at regarding the nature of the relationship, which most likely indicates the relationship between drug use and delinquency is reciprocal - criminal activity leads to drug use and drug use leads to criminal activity. Treatment and prevention programs designed to curb adolescent drug use are described, including maintenance and detoxification programs, therapeutic communities, outpatient programs, the “Just Say No” campaign, education programs, and life skills training approaches. The modest impact of some of these programs coupled with the ready availability of drugs in the community has lead to some alternative responses to adolescent drug use that combine law enforcement with drug treatment, such as juvenile drug courts. Four discussion questions are offered that focus attention on the connection between drug use and delinquency and drug prevention and treatment programs. Key terms are listed. Tables, figures, boxes