The war against substance abuse continues in today's society and the sports world often seems to be in the middle of all the attention, especially among the media. New recreational drugs arrive on the scene from time to time, much like GHB, but the predominant substances of abuse continue to be marijuana, cocaine, and alcohol. As research evolves in efforts to stay current and determine any potential performance effects of new substances, the literature has changed very little regarding the more common recreational drug and their effects on athletic participation. New studies are emerging comparing recreational drug use among athletes versus nonathletes. Findings include differences among these groups regarding individual sports, team sports, contact versus noncontact sports, and gender-specific sports. Higher risk-taking behavior contribute to these findings and is known to be more prevalent among an athletic population. Overall, illicit drug use in America in 1996 remained about the same as in 1995 after rising steadily since the early 1990s. About 13 million Americans used drugs at least monthly in 1996, up slightly from 12.8 million in 1995. Teenage drug and alcohol use fell to 9% in 1996, down from 10.9% in 1995. Attempts to recognize the early signs of substance abuse and identify those athletes "at risk" of experimenting with elicit drugs are paramount to the optimal treatment response program. The preparticipation examination remains the best initial format for establishing a sound physician-patient relationship. A thorough history including risk factors, family history, and personnel tendencies toward substance abuse should be obtained followed by an ongoing relationship between the athlete and his team physician. The better rapport between the athlete and team physician, the higher likelihood of early recognition of a developing substance abuse problem. Likewise, the earliest intervention usually leads to the most optimal treatment response.