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Complex behaviors such as the initiation and use of alcohol result from an intricate interplay between genes and environment. Genes shape physiological and behavioral responses to alcohol that can influence the likelihood that a young person will begin using alcohol and that he or she will progress to problem drinking. Youthful alcohol use also can have an impact on unfolding developmental patterns, and for some, early use becomes the entry point for pathways that lead to problems with alcohol. This article first describes research on genes that may be involved in the development of alcohol problems and how genetic factors may contribute to adolescent alcohol use. It then examines how the changes that occur during adolescent development-in alcohol metabolism, in the brain, and in the endocrine and stress response systems-may affect how a young person experiences alcohol and the likelihood that he or she will develop alcohol use problems. [ABSTRACT FROM AUTHOR]