Adolescent substance abuse: diagnostic and treatment issues.

For teenagers, substance use initiation peaks between 16 and 18 years of age, with the greatest use occurring over the subsequent four years, after which time there is a significant reduction in usage. Factors associated with adolescent substance abuse include rebelliousness, relative indifference to school, tolerance for social deviance, family disruption, parental tolerance of alcohol or other drug use, and early onset of drug use. One major problem for teenagers is that the diagnosis and treatment of adolescent substance abuse is based primarily on adult models of alcoholism.