[Substance abuse in adolescents].

During adolescence, addition per se is not a major issue. Drug use is either a physiological experience or a symptom related to psychopathological condition and other forms of psychic suffering. The most relevant parameters predictive of poor outcome are the precocity of the first experiences, the auto-therapeutic use, the repetition of drug intake, and the various types of individual and social vulnerability. Assimilated to addiction, some inappropriate and compulsive ways to modify body shape (dieting, and anabolic steroid abuse) are seen in teenagers although they are difficult to identify. Prevention and treatment in youths requires a pragmatic attitude from the adults, avoiding minimisation or dramatization of drug use and its consequences. Particular attention has to be paid on the detection of underlying psychiatric disorders. Treatment of problematic drug abuse in adolescents is based on both contextual interventions including systematic support of the families and a multidisciplinary approach.