Alcohol use among adolescents has increased during the last 10 years. Adolescent substance abuse is believed by some to be the most commonly missed pediatric diagnosis. Adolescents who use drugs are most likely to visit a physician's office with no obvious physical findings. Substance abuse problems are more likely to be discovered by physicians when adolescents are injured in accidents occurring while under the influence, or when they are brought for medical services because of intentional efforts to hurt themselves. Substance abuse , as a disorder , refers to the abuse of illegal substances or the abusive use of legal substances.
Alcohol is the most common legal drug of abuse.
Substance dependence is used to describe continued use of drugs or alcohol, even when significant problems related to their use have developed. Signs include an increased tolerance or need for increased amounts of substance to attain the desired effect, withdrawal symptoms with decreased use, unsuccessful efforts to decrease use, increased time spent in activities to obtain substances, withdrawal from social and recreational activities, and continued use of substance even with awareness of physical or psychological problems encountered by extent of substance use. Cultural and societal norms influence acceptable standards of substance use. Public laws determine the legal use of substances. The question of whether there is a normative pattern of substance use remains controversial.