Adolescent chemical dependency is now a recognized, diagnosable entity. In most respects, it mimics the diagnosis in adults. The practicing physician has some obligation to be familiar with changing trends in drug use and should have the skills to define problem use and assess risk. The physician should also address the issue as part of routine clinical interactions with patients and be aware of community resources for further assessment and treatment. Finally, the physician should be an advocate of the young patient and be helpful to parents in understanding the problem, but he or she should not be the parent's agent when asked to commit the adolescent for treatment or carry out drug abuse screening. The problem of adolescent substance abuse is a pre-eminent social problem. The problem must be addressed on many fronts. The role of the physician provides a key component of the solution.