CASE Philip, a 14-year-old male, is brought to your office by his anxious parents who recently discovered that he was using marijuana. Over the past 2 months, he has appeared moody, irritable, and has been losing interest in his school work. His parents had attributed these behavior changes to “teenage years” until his mother discovered a marijuana cigarette in his room. His father responded with anger directed at the youth. Philip had a happy and productive childhood before this event. He was a solid “B” student with several friends and a modest interest in participatory sports. He has two older siblings in college. The family was close and previously had enjoyed time together. Philip’s father stated that the use of drugs was absolutely forbidden in his family, and he felt that Philip had “let ‘him’ down.” The journey through adolescence is an eventful time for clinicians, parents, and youth. the youngster has a multitude of developmental experiences in her/his educational, social, sexual and psychological life for the first time. The discovery of drug use by a concerned parent in this case illustrates one of those new events. Both Drs. Schonberg and Heyneman approach this case from a contextual and developmental perspective. Dr. Heyneman cautiously differentiates “drug use” from a “primary drug problem.” Dr. Schonberg emphasizes the importance of knowledge about the epidemiology of drug use, i.e., experimentation in early adolescence must be seen as a problem worthy of careful clinical evaluation. For each clinician, the evaluation is guided by a need to understand the marijuana use in the context of the youngster’s previous medical and psychological history, his educational performance, social skills, and family patterns. Both commentators agree that, without more information, it would be premature to conclude that Philip’s case is consistent with a developmental phase with drug experimentation. Dr. Heyneman’s review of specific criteria that may differentiate a minor drug problem from a major one is especially helpful for the primary care clinician. The decision to refer for further evaluation and counseling is difficult. Availability of services (financial and geographic factors) and willingness of the patient and family to follow through on a referral are critical issues. Some pediatricians with special interest and training in adolescent developmental problems may be qualified to manage a patient like Philip when the initial evaluation suggests that the problem is limited to drug experimentation in a youth who is functioning well in other spheres.