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In this paper i present a theoretical formulation based on empirical observations. My thesis is that, given the presence of three factors, one can predict a high degree of probability that certain adolescents will become drug dependent. Although intrapsychic and environmental factors related to early life are obviously significant, my formulation is directed toward a particular reorganization of psychic structure during the adolescent phase of development. I also speculate that some adolescents, in spite of a relatively normal early development, begin to take drugs because of intrinsic factors related to a pathological response to the resurgence of sexual and aggressive drives at the onset of puberty. By way of introduction, listen to four very disturbed hospitalized adolescents with different diagnostic syndromes who were admitted because of drug dependence. The onset of severe psychic disorganization occurred with the advent of early adolescence; the symptoms are unqiue to this phase of development even though the diagnoses refer to previous developmental factors or solely to the adolescent process.
Dianne, age 15, was an attractive girl who described her problems with a friendly ease: “I have bouts of depression, and I'm not doing well at school. I use alcohol and marijuana. I have a lot of