Among adolescents, a high prevalence of co-morbidity exists between substance use and mental health problems. It was revealed that rates of depression and disruptive disorders among alcohol abusing or dependent adolescents were 3 and 10 times greater than among adolescent alcohol abstainers, respectively. An important first step in clinical engagement and treatment planning for such youth involves eliciting accurate information about their patterns of and preferences of substance use. Mount Sinai Hospital's Adolescent Health Center provides comprehensive health, mental health, and reproductive services in a confidential, adolescent-centered environment. Studies have consistently reported that family and peer pro-drug attitudes and behaviors are powerful risk factors for adolescent substance abuse. Adolescents with parents who have permissive attitudes towards alcohol and other drug use are more likely to use drugs. While national studies of adolescent substance use have largely Caucasian samples and report lower rates of lifetime substance use among minority adolescents, the majority of our sample is of minority adolescents.