Objectives: To determine the prevalence of specific drug use in adolescents attending an adolescent health clinic and to compare current rates with a similar previous study. Design: Blinded and anonymous urine samples obtained from patients presenting for routine health care were tested for the presence of cannabinoids, phencyclidine (PCP), amphetamines, opiates, and cocaine. Setting: Adolescent medicine outpatient clinic. Patients: Patients were between 12 and 21 years of age. Specimens from

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... 13 patients in 1995 to 1996 and 1312 patients in 1989 to 1990 were tested. Main Outcome Measures: Current drug use rates were compared with a similar screening of patients conducted in 1989 to 1990. Comparisons between studies were made on the basis of specific drug, age, and sex. Results: For the most recent patient group, 14% were positive for 1 or more drugs and 13% were positive for cannabinoids. Males were significantly more likely to test positive for drug use than females. The oldest adolescents were more likely to test positive for drug use than younger adolescents. Comparing the 2 study year cohorts, patients tested recently were significantly more likely to have urine tests positive for at least 1 drug and cannabinoids in particular and less likely to have urine tests positive for cocaine. Conclusions: There has been an increase in positive urine tests in patients seen in our ambulatory clinic, with a strong shift toward cannabinoids and a shift away from cocaine. Practitioners need to be aware that drug use patterns in adolescents can shift relatively abruptly and counseling should be targeted to current drug use patterns.