Although recent surveys of youths in the general population indicate that drug use has declined, drug use among juvenile detainees remains at a high level. These youths, who are often experiencing multiple problems, are a seriously underserved population group in our society. A review of the literature, and results from an ongoing longitudinal study of juvenile detainees in Tampa, Florida, documenting their drug use and related problems, lead to the identification of five key areas for policy and program development: early intervention; quality screening and assessment; providing quality, community-based services; improving linkages between community agencies; and continuity of services. Youths entering the juvenile justice system often require repeated interventions over a protracted period, reinforced by improvements in their social, vocational, and educational skills, if their lives are to be directed in socially responsible ways. A national effort is needed to address the poignant issues presented by these youths and their families.