This chapter is devoted to describing variations in the course and outcomes of adolescents with alcohol or other drug problems. At the outset, we should note that teens using substances are a heterogeneous group, with wide variation in the reasons for, the correlates of, and the consequences of their substance involvement. Some adolescents who try alcohol or other drugs experience few clinically significant problems. In fact, several investigations have suggested limited substance use may be positively related to psychosocial functioning and adjustment in adolescence (Labouvie, 1990; Maggs, 1997; Marlatt, 1987; Shedler and Block, 1990; Silbereisen and Noack, 1988), and others have found adolescent substance use does not reliably predict the subsequent development of alcohol or other drug use disorders (Bukstein, 1995; White, 1992). However, other adolescents who use substances experience dramatic negative consequences because of their substance use, and place themselves at long-term risk for substance use problems. For these teens, early alcohol and other drug use may lead to serious adjustment and substance use problems later in life (e.g., substance abuse and dependence) (Hill et al., 2000; Kandel, 1980; Newcomb and Bentler, 1988; White, 1987). In sum, adolescents who become involved with alcohol or other drug use are far from a monolithic group, and as a result demonstrate a variety of courses and outcomes. Our goal in this chapter is to identify and discuss some of the most important determinants of what happens to adolescents who have developed drinking or drugging problems.
