In recent literature, adolescent gambling has become a hot topic of discussion. There are several reasons for this phenomenon. During the past decade, legalized gambling, such as lotteries, high-stakes casinos, and video lottery terminals have expanded rapidly. In the developmental course, adolescents are susceptible to the engagement of health risk behaviors and frequently disregard their possible negative consequences (Clayton, 1992). With regard to gambling, the predominant belief is that it is a mode of entertainment and it has very few, if any, negative consequences. It is partly due to this perception that implementing programs to treat adolescents with gambling problems have not been widely accepted or developed in the past. It is known that some adolescent problem behaviors are connected with morbidity and mortality (e.g., automobile accidents resulting from drinking and driving) (Chassin & DeLucia, 1996). The prevalence data on adolescent gambling behaviors are provocative. Among young people, gambling involvement is common, with some gambling occurring among most American adolescents (Jacobs, 1989a, 2000, in this volume; Stinchfield & Winters, 1998). The estimates of problem or pathological gambling rates among youth, while not excessive, range from 1'9% past year (median = 6%), while pathological gambling rates are two to four times higher than that of adult populations (Gupta & Derevensky, 1998a; Jacobs, 2000; National Research Council, 1999; Shaffer, Hall & Vander- Bilt, 1997). Youth who are in psychiatric hospitals, chemical dependency programs and juvenile detention centers display gambling rates that are approximately double that of adolescents from school or community samples (Stinchfield & Winters, 1998). The young person who is considered to have a gambling problem or who is a compulsive gambler has been connected to a rise in criminal activities and delinquency, familial difficulties, and poor academic performance (Fisher, 1993; Gupta & Derevensky, 1997). It is therefore safe to assume that gambling behaviors can lead to delinquency and that delinquent behaviors can lead to gambling among youth (Gupta & Derevensky, 1998a). In retrospective reports of adult pathological gamblers, a higher percentage of these individuals have indicated that they began their gambling during adolescence (National Research Council, 1999). Discussions about the origins and course of adolescent gambling often point to the apparent connection between adolescent gambling and drug use.2 Researchers have noted that the prevalence rates of general gambling involvement and drug use are in most cases are comparable, and that many behavioral and social consequences of each domain are similar. Researchers have also recognized that several psychosocial factors linked to adolescent drug behaviors have emerged as correlates of gambling behaviors as well (Lesieur, Blume & Zoppa, 1986; Stinchfield, in this volume; Stinchfield & Winters, 1998).3 This chapter explores the extent to which insights about adolescent gambling behaviors can be enhanced by studying the relationship between gambling and drug use behaviors. Clearly, we are a distance from knowledge parity with respect to these two behavioral domains. Relatively little is known about the origins, course, and responsivity of the treatment of gambling compared to that of drug involvement. In this chapter, we will focus on five issues pertaining to the relationship of gambling and drug use: definitions and measurement, prevalence of the two domains including their co-occurrence, psychosocial factors that may mediate and moderate these behavioral domains, and prevention and treatment implications.