The broad, long term objectives of this study are 1) to prevent alcohol and other drug abuse among adolescent mothers, and 2) to develop interventions for alcohol and drug abusing adolescent mothers based on an understanding of risk factors and cultural differences in alcohol and drug use within this population. The proposed study addresses several Maternal and Child Health and Alcohol and Drug Abuse Objectives for the year 2000 set forth by the Public Health Service. The specific aims of this project are 1) to identify the prevalence of alcohol and drug use during the first six months after the birth of a child among a sample of adolescent mothers; 2) to identify patterns of alcohol and drug abuse across prepregnancy, prenatal and postpartum periods; 3) to identify predictors of alcohol and drug use at three and six months postpartum; and 4) to examine differences in the prevalence, patterns and predictors of alcohol and drug use across these same time periods among Black as compared with White adolescent mothers. A prospective, cohort design will be used in this study. A total of 400 adolescent mothers will be enrolled, including 200 Black and 200 White adolescents. Data on lifetime drug use, and drug use during pregnancy will be collected while patients are on the adolescent postpartum ward at the University of Texas Medical Branch Hospital, Galveston. Assessments of drug use over the previous 30 days will be conducted at three and six months post delivery. It is hypothesized that prevalence of alcohol and drug use will be higher among White as compared with Black adolescents. Predictors of alcohol and drug use among adolescent mothers will include: a) perceived lack of family support; b) greater drug use by peers and partners; c) greater isolation from peers; d) greater stigma associated with teenage parenthood; e) lack of prenatal care; f) depression; g) low self-esteem, h) school failure; i) prior physical or sexual assault; and j) lesser economic resources. Results of this study will help identify risk factors for alcohol and drug use among adolescent others leading to the development of clinically-based intervention programs for this population.