The author offers a succinct and practical guide to assessment of drug abuse in adolescents, characteristics of progression of abuse, and issues in treatment of these patients. If a chemically dependent adolescent behaves as though drugs are more important than people, there is cause for serious concern and vigorous treatment. Massive denial protects these youngsters from the recognition that rather than becoming independent they have become desperately dependent both upon the substance of abuse and upon others to rescue them. Gradual development of a strong transference and "human relationship" with a therapist, together with abstinence and group support, allows the emergence and treatment of underlying psychopathology.