Willenbring ML, Ridgely MS, Stinchfield R, Rose M. 1991. Application of Case Management in Alcohol and Drug Dependence: Matching Techniques and Populations . DHHS Pub. No. ADM 91-1766. Rockville, MD: National Institute on Alcohol Abuse and Alcoholism.

Studies of substance use among youth go back a half-century in the United States (Glad, 1947). Four decades ago an official at the World Health Organization first identified a worldwide pandemic of substance abuse among youth (Cameron, 1968). Since that time, investigators have identified the association of substance abuse with numerous social and behavior problems among youth, including:

• delinquency (Farrow and French, 1986);

• risk of physical and sexual abuse (Dembo et al., 1987);

• suicide, at least in some subgroups of adolescents (Berlin, 1987; Bechtold, 1988; Dizmang et al., 1974; Grossman et al., 1991);

• driving while intoxicated (Harwood and Leonard, 1989);

• illegitimate pregnancy (Gilchrist et al., 1990); and

• running away, especially among females (Fors and Rojek, 1991).

Considerable information exists regarding the epidemiology and clinical characteristics of adolescent substance abuse (Johnson and Marcos, 1988). Young substance abusers are more apt to abuse alcohol, cannabis, inhalants (Beauvais et al., 1985; Padilla et al., 1979; Schwartz, 1988; Westermeyer et al., 1994) and less apt to abuse cocaine and heroin. Antisocial behavior is especially apt to accompany substance abuse in adolescents (Osuna and Luna, 1988) although many cases do not involve such behavior. High rates of several comorbid psychiatric disorders accompany early onset substance abuse in adolescents (Burke et al., 1994; Deykin et al., 1992; King et al., 1993; Myers et al., 1990; Westermeyer et al., 1994). Institutionalized youth are at particular risk to substance abuse (Cockerham, 1975), as are particular ethnic and socioeconomic groups (Cockerham et al., 1976).

Prevention services for adolescents have been developed and well studied (Perry, 1986). However, much of these data indicate a delay in substance use rather than prevention of eventual substance abuse. Most data on adolescent treatment focuses on description of services, anecdotal reports, or uncontrolled studies (Tarter, 1990). Data on outreach, early intervention, treatment outcome, and cost efficacy for adolescent substance