Sensitive and specific tests are now available for marijuana, cocaine, and a host of other drugs. This availability makes the decision about when to use these tests a crucial issue in the care provided to adolescents. When to suspect drug abuse and acute intoxication, what to do with the drug test result, and whether or not to do routine screening in schools or in the pediatrician's office, especially if a drug test is specially requested by a parent, are central. Screening of body fluids for drugs is recommended for adolescents with mental state or performance changes, psychiatric symptoms, or acute-onset behavior states.