Youth who use alcohol and other drugs persistently face an array of possible consequences, including:

• School problems. A lowered commitment to education, declining grades, absenteeism from school and related activities, increased potential for dropping out, and higher truancy rates are linked to adolescent substance abuse (Hawkins, Catalano, and Miller, 1992). Students' cognitive and behavioral problems precipitated by alcohol and other drug use not only affect their own academic performance, but also may disrupt learning by their peers (BJS, 1992).

• Health and safety consequences. Accidental injuries, physical disabilities, diseases, and possible overdoses are among the risks for alcohol- and drug-using youth. Drug-related suicides, homicides, accidents, and illnesses may result in death for some youth. Alcohol-related traffic fatalities have declined for young drivers, but youth still are overrepresented in this area. The volume of drug-related hospital emergency episodes for youth ages 12 to 17 reported by the Drug Abuse Warning Network (Greenblatt, 1997), a national survey conducted annually by SAMHSA, rose steadily beginning in 1992 and peaked in 1995 at 60,881. A slight decline, to 59,072 emergency room episodes, was reported in 1996.

  Use of alcohol and other drugs increases the risk that youth will contract HIV or other sexually transmitted diseases. Injection of psychoactive substances with unsterile needles and other equipment is strongly associated with transmission of HIV. The effects of mood-altering substances, such as poor judgment and diminished impulse control, may result in youth being more likely to engage in unprotected sex. Diagnosed cases of AIDS are relatively low among teenagers compared with most other age groups; however, because there is often a long latency period between infection with the virus and the onset of AIDS symptoms, it is conceivable that many young adults with AIDS may have been infected with HIV as adolescents.

• Peer relationships. Youth who use alcohol and other drugs may be alienated from and stigmatized by their peers. They often disengage from school and community activities because of their substance abuse, depriving their peers and communities of the positive contributions they might otherwise make.

• Social, developmental, and emotional consequences. Youth who abuse alcohol and other drugs often experience depression, developmental lags, apathy, withdrawal, and other psychosocial disorders. Substance-abusing youth are at higher risk for conduct problems, depression, suicidal thoughts, attempted suicide, completed suicide, and personality disorders. Marijuana use has been shown to interfere with short-term memory, learning, and psychomotor skills. Motivation and psychosexual development also may be impaired by marijuana use (BJS, 1992).

• Family Issues. Substance abuse also jeopardizes many aspects of family life and may both lead to and result from dysfunctional families. Siblings and parents are affected profoundly by youth involved in alcohol and other drug use. Substance abuse and its consequences may drain family financial and emotional resources (Nowinski, 1990; BJS, 1992).

• Social and Economic Costs. Monetary expenditures and emotional distress related to alcohol- and drug-related crimes by youth affect many others in the community. Often there is an additional burden for the support of adolescents and young adults who are not able to support themselves. Further, substance-abusing youth increase the overall demands for treatment of substance abuse and medical conditions (Gropper, 1985).