try to conceal the extent of their substance use from parents. While the use of biological samples (e.g., urine tests) may be ill suited for assessing lifetime patterns of substance use, they are recognized as useful in clinic referred samples and for assessing treatment compliance. b) Are DSM defined abuse and dependence criteria appropriate indices in children and adolescents? DSM12 criteria for substance abuse and dependence were largely developed for use in adults and there have been ongoing concerns about the extent to which they may be appropriate for adolescents or young adults. Some symptoms (e.g., withdrawal) only occur after many years of heavy drinking and, given low prevalence in adolescence samples, may have limited utility for this age group.13 Conversely, some symptoms of abuse, particularly items relating to getting into trouble with friends or family members may occur, because of parental restrictions, in adolescents who drink alcohol or use drugs only infrequently. Martin and Winters9 described such individuals as “diagnostic imposters”. Similarly, there are several dependence symptoms with high prevalence among adolescents, (particularly “tolerance” and “drinking more or longer than intended”) that identify many adolescents with relatively low levels of consumption.14 c) The extent to which normative behaviors may
