The diagnosis and treatment of chemically dependent adolescents with a second diagnosis of learning disabilities (LD) or an attention-deficit hyperactivity disorder (ADHD) poses a challenge. Like other so-called dual diagnoses, these conditions must be assessed against the background“noise”of the adolescent chemical dependency syndrome. This syndrome is coincident with the onset and cessation of chemical dependence and abuse. A diagnostic framework for assessing chemically dependent adolescents is presented, with specific reference to the differential diagnosis of LD and ADHD from other conditions. The role of LD and ADHD is assessed with regard to being a risk factor for chemical dependence in adolescence. Treatment approaches, on both an inpatient and outpatient basis, with the chemically dependent adolescent who also has an LD or ADHD are discussed.