This article provides an overview of existing evidence regarding risk and prevention factors in adolescent substance abuse from a biopsychosocial viewpoint. It is believed that this approach offers a practical model for the integration of inherently complex factors into the clinical setting. These factors cannot be isolated from the influences of the greater society, such as the school system or homelessness. Prevention and treatment issues must approach the impaired adolescent with a multifactorial and comprehensive plan that integrates multidisciplinary involvement.