A review is presented of studies dealing with the prevalence and consequences of drug and alcohol use and abuse among youth. It is noted that substance is widespread in the United States, with nearly all high school seniors reporting alcohol use and nearly two-thirds reporting the use of cigarettes and illicit drugs. Some of the challenges of childhood and adolescence are discussed, and ways in which problematic drug use and other risk-taking behaviors can develop are identified. Major theories predicting and explaining substance abuse are critiqued for their heavy emphasis on individual factors, and a social stress theory is proposed as an alternative. An overview is presented of existing prevention strategies, including drug education, behavioral skills training, and more community based approaches. Identification and treatment issues are addressed, and a multiple gating, early identification procedure and referral guidelines for high-risk youth are proposed. Practical guidelines for translating these theories and strategies into practice are provided, together with a detailed skills-based curricula. Materials, instructional and evaluation strategies, and resources are included. Emerging trends in substance abuse prevention also are noted. 9 figures, 1 table, author and subject indexes, list of 35 practitioner guidebooks, and approximately 250 references.