Risk-taking behavior plays a significant role in the lives of adolescents. Adolescents engaging in risk behaviors such as substance use and risky sexual activity are at increased risk for contracting STDs, unplanned pregnancy, and other health problems. Consequently, children of substance abusers are at even greater risk for engaging in maladaptive behaviors given their social environment and the potential exposure to parental substance use/abuse. Although the empirical literature on adolescent risk-taking behavior is vast, less empirical research has examined how parental substance use is associated with the health outcomes of adolescent children of substance abusers, especially children of parents who use illicit substances. This study proposes a framework to synthesize the research on the health outcomes of adolescent children of substance abusers and provides recommendations for future study. (Contains 1 figure.)