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OBJECTIVE: This article reviews drug use trends among ethnic groups of adolescents. It identifies similarities and differences in general, and culturally specific variables in particular, that may account for the differences in drug use rates and the consequences of drug use. METHODS: The authors review trends in drug use among minority and nonminority adolescents over the past 25 years and propose an explanatory model for understanding the factors that affect adolescent drug use. Sources of variance examined include factors common to all adolescents, factors unique to certain ethnic groups, temporal influences, location and demographic variables, developmental and socialization factors, and individual characteristics. RESULTS: Most of the variance in adolescent drug use is due to factors that are common across ethnic groups. CONCLUSION: This finding should not overshadow the importance of addressing ethnocultural issues in designing prevention or treatment interventions, however. Although the major factors leading to drug use may be common across ethnic groups, unique elements within a culture can be used effectively in interventions. Interventions also need to address culturally specific issues in order to gain acceptance within a community.