Adolescence is a challenging time for many young persons. Navigating the academic, personal/social, and career planning challenges associated with adolescence indeed is challenging even with excellent school, family, and community support. For those adolescents struggling with substance use and abuse, these challenges become even greater. School counselors can provide timely and relevant interventions for adolescents with substance abuse issues if the counselors become well versed in warning signs and meaningful strategies. This article summarizes the warning signs of adolescent substance abuse for prescribed and illicit drugs and offers strategies and considerations for counseling.