It has been reported that drug-related visits to emergency department (ED) by youth have been increased in recent years. We aimed to determine the frequency of, and associated risk factors for, substance abuser adolescents presenting to the emergency department. We conducted a biphasic (retrospective-prospective), observational study of all adolescents, presenting to our emergency department with complaints related to recreational drug use and having a positive urine drug screening from January, 2013 to December 2016. To obtain some spesific data, a telephone interview was done. Baseline demographic and clinical data were obtained. During the study period urine toxicology screen was positive for illicit drugs in 131 (0.9%) patients. The total of substance users by years were respectively 17 (13%) in 2013, 27 (20%) in 2014, 39 (30%) in 2015 and 48 (37%). The median age was 16 years and 65% were male. Majority of substance users (61%) had neuropsychiatric complaint. Amphetamine type stimulants (60%) were the most commonly used substance. Rate of cigarette and alcohol use in this adolescent group was respectively 95% and 88%. This group also had some specific features such as low income (59%) and single-parent family (54%). Our findings suggest that the number of illicit drug use has been steadily increasing among adolescents. The most common identified substance was amphetamine type stimulants. They had poor socioeconomic conditions.