This presentation focuses on issues and trends in relation to youth substance misuse. Presenting research in relation to professionals understanding of risk factors for substance misuse by young people and explore approaches to intervention especially from a family/systemic perspective. Highlighting the importance of parents and other adults identifying risks for young people at an early stage in order to delay onset or avoid substance use/abuse in the first instance. In relation to substance misuse it is observed that risk and protective factors exist in equal measure within different contexts, including within the individual, family, peer group, school and community settings. The enhancement of decision making by young people may delay or inhibit their engagement in harmful activity including substance misuse. A multi-agency response is required where children’s lives are affected personal or familial substance misuse and the identification of needs forms the basis for the establishment of integrated care plans framed within multi-disciplinary and inter-agency collaboration.