Adolescents have access to a variety of legal or illicit substances that they use to alter their mood or "get high." The purpose of this review is to provide an overview of common substances adolescents use to get high, including the illicit substances synthetic marijuana or "Spice," salvia, MDMA, synthetic cathinones, and 2C-E. Dextromethorphan and energy drinks are easily accessible substances that teenagers abuse. The toxic effects of common ingestions and treatment of overdose is discussed to inform pediatric providers who provide care for adolescents. J Pediatr Health Care. (2013) 27, 135-144.