"Teenagers," said Dr. Robert Millman, a professor of public health and psychiatry at Cornell University, "have a basic and profound fear of the future. They don't know if they'll make it. The message is you make it if you're tough enough; otherwise, you fail."

So what do some teenagers do? According to Dr. Millman, who led a forum last week at Katharine Cornell Theatre in Tisbury, they seek "predictable sources of pleasure." It could be drugs, alcohol or sex.

No surprise, some teenagers on Martha's Vineyard are engaging in all three arenas, and in drug and alcohol use, they're doing it at rates that are higher than their peers in the rest of the state, according to a survey released last year.

But just how big a problem is it? To Dr. Millman and one recent high school graduate who was part of the forum's panel, the behavior is all part of being a teenager at the turn of the century when nationwide drug use, at least, is on the upswing.

"During the adolescent years, experimentation with drugs is normative behavior," said Dr. Millman, who is an expert on addiction.

Plus, while drug use waned on a national level beginning in the late 1970s, it started to climb again by around 1993, he said. "When the perception is that drugs are dangerous, use goes down," he added. "Kids now perceive drugs are much less dangerous."

And Maria Gaskill, who is headed to New York University next month for her first year of college, drove home the point. When the panel's moderator, Dr. Charles Silberstein, also a psychiatrist, posed the question, "Are drugs and alcohol a problem?" the answer was straightforward.

"The definition of the word ‘problem' is jaded. Kids don't see it as a problem," she said, "while parents do. But going to the parties on the weekend is the norm. Cops breaking it up, that's the norm."

But if drinking and smoking pot are considered "normative" behavior, then the next question is how to minimize the risks associated with it. Models based on punishment, abstinence or prevention, Dr. Millman said, don't really work.

In his opinion, the federal government wastes billions of dollars on enforcement and interdiction. "The government solution is more jails, mandatory sentencing and make kids like adults and put them away," he said.

Even efforts at treatment for teenagers fall short. "There's no good program existing," he said. "The problem is that programs open up a youth house and support a 12-step program that sells a disease model [saying] you can't have a drink for the next 64 years. Kids are totally confused, and they can't accept the language or the goals."

But the problem is that "if you argue for tolerance, you seem soft," said Dr. Millman. A better solution would be getting teenagers plugged into the community, doing things that make them feel connected. After all, in Dr. Millman's view, "the main reason teenagers get off track is because they don't know there's a place for them."

Panelist Pam Carelli, founder of the Island SafeRides chapter, seemed to offer one antidote while acknowledging the reality of the problem. "I see alcohol and drug use as very real issues, but not something we can make go away," she said. Tossing aside the "Just Say No" approach, Ms. Carelli advocated giving teenagers the chance to do something real, like man a dispatch center and drive a car all over the Island, helping their peers get home safely. "We need to give them opportunities to find their niche," she said.

That seemed to be a dominant theme of the evening. Joy Robinson-Lynch, a panelist and a therapist, argued that teenagers need many chances to make decisions and to take risks.

"They need to live with the consequences and reflect on the experience," she said. "And they need real work that matters."

No such forum would be complete without touching on the topic of a teen center. A few people pushed for a central spot exclusively for teens. Instead, Mrs. Robinson-Lynch harkened back to the old Wintertide Coffeehouse which drew a cross-section of ages.

"We need some kind of place where kids can go and know that kids will be there," she said. High school senior Elise Chapdelaine stood up to say how badly her peers need such places.

But Miss Gaskill warned that any teen center would be slow to gain acceptance. Again, she was blunt about what she perceived as a pack mentality of Vineyard teens. "It's not going to be a quick fix," she said. "If there's a three-keg party on a Friday night, the majority goes to that party because everyone thinks everyone else is doing it."

But then came Amanda Root, who seemed to have cracked the code for an ideal model. The director of the Railroad Street Youth project in Great Barrington, Ms. Root said her program has no real estate, just a mission to "empower youth and promote their self-worth."

How do they do it in the Berkshires? Open to anyone aged 14 to 24, the young people mount plays, hip-hop shows and skateboard competitions. They work with local artists and musicians, and "they pair off with adults whose careers they want to pursue," she said.

"What do effective parents do?" asked panelist Peg Regan, regional high school principal. "When there's a family history of alcoholism, how do you talk to a kid about what not to do?" Of course, there were no quick and easy answers, but Mrs. Robinson-Lynch encouraged parents to talk to their teenaged children about how to make choices. "Kids want to know why parents hold the values they hold," she said. "Kids are dying to hear this from their parents."

Still, others in the audience weren't buying the tolerance argument.

Dr. Millman said that abstinence commitments tend to fade, and they work best when a teenager has been in some very real trouble.

The forum was sponsored by the Vineyard House, a grassroots organization that knows about making what seems impossible, entirely possible. Amidst a real estate market that has locked out so many, this group now owns three houses giving a home to Islanders in the early stages of recovery from alcohol or drug addiction.

But Dr. Silberstein, one of the founders of Vineyard House and now head of the newly formed Foundation for Island Health, said finding the right answers to questions about teen drug and alcohol use is tricky and not solved in just a couple meetings.

"We should be doing this over and over again," he said. "This is not a teen problem. This is a community problem, but there are answers and we can create them."