Students in the High School Substance Usage Recovery Group are often referred by parents or school authorities after concerns about their drug or alcohol use have been raised. We discuss the origins of use, the physiological and psychological consequences of use, and coping methods for illicit substance use in the group. While the majority of participants are in high school, some middle students may be suitable. Regular drug testing is initially needed, and students who are unable to overcome their addictions are assigned to an Intensive Outpatient Program.