Dually diagnosed adolescents suffering from both severe emotional disturbance and substance abuse/addiction constitute a special population which poses a challenge to health professionals in special education as well as clinical settings. The prevalence of substance use, abuse, and addiction has been shown to be significantly above the national average for severely disturbed adolescents. Typically, the dually diagnosed adolescent falls between the cracks of both the mental health and chemical dependency treatment communities. The interaction of vulnerable individuals, external traumatic stress, and a particular drug effect may synergistically cause dramatic clinical symptoms, including personality changes and deficits in interpersonal skills. The relationship between suicidal ideation and self-destructive behavior as an intrinsic aspect of substance abuse is discussed, and the need for specific treatment programs and specialized facilities is cited. (JW)