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Substance abuse has been an intractable societal concern in the United States for more than half a century. The recent opioid epidemic has only accentuated this problem. Adolescents are significant long-term contributors to the crises due to their susceptibilities to drug abuse and impressionable age. This study examines the causes and effects of drug abuse and misuse in adolescents, and the attendant vulnerabilities of the adolescent brain to drug use and the risk thereof. Adolescents are particularly vulnerable to substance abuse. In 2020, people of ages 15 to 24 experienced the greatest percentage increase in deaths due to drug overdose. Despite the discouraging statistics, there has been a significant and accelerating scientific progress toward the prevention and treatment of substance disorder (SUD). This study further examines the impacts of drug abuse and misuse through the ophthalmic prism of criminological lenses underlined by the strain theory, developmental theories, differential association theory, social control and self-control theories. With the urgency of the situation, a framework for countering, treating and rehabilitating adolescent from drug abuse/misuse were also suggested.