To examine the role of public health agencies (PHAs) in providing access to drug treatment services for adolescents by describing the proportion of youth who obtain access to these services through PHA involvement in school health clinics, juvenile drug courts, and other community agencies.Analysis of cross-sectional telephone interview data collected from 1999-2003 from a national sample of 1793 PHA key informants from communities surrounding schools in the nationally representative Monitoring the Future (MTF) study of 8th, 10th and 12th grade students.Fifty-eight percent of youth in the MTF sample were served by PHAs that participated in some way in school health clinics, with 30% served by PHAs that provided resources for drug treatment in schools. Twenty-nine percent of youth were served by PHAs involved in juvenile drug court (JDC) programs, 23% by PHAs acting as JDC referral agencies, and 13% by PHAs providing direct JDC drug assessment, treatment and monitoring services. In addition, 44% of youth were served by PHAs providing drug treatment resources in community settings. Treatment access for youth through PHAs varied by region, race/ethnicity, urbanicity, community income level, and youth population density. The largest variation occurred in access via JDC programs.PHAs may help bridge gaps between drug treatment need and service provision for adolescents who need access to drug treatment services. Strengthening the linkages between PHAs and schools, juvenile drug courts, and other community settings may serve to increase youth access to drug treatment.