<p>“Brat culture,” an aesthetic that revives early-2000s fashion, attitudes, and behaviors (e.g., smoking, drinking, and drug use) framed as rebellious and socially defiant, has emerged as a defining lifestyle among youth. Brat culture is marked by a confident, unapologetic tone that equates substance use with self-expression and non-conformity. The increasing depiction of risky behaviors in popular media—particularly among adolescents—necessitates more accurate substance-use assessments in clinical settings. Current tools and protocols may fall short in addressing this cultural shift. Providers should expand questioning beyond traditional drug categories to encompass new circulating trends. Public health campaigns must evolve to meet youth where they are—on social media, at concerts, and within fandom spaces—delivering narratives that are engaging and aesthetically savvy. As young people gravitate toward brat culture, there is an urgent need to anticipate its effects, adjust our tools, and act decisively to protect adolescent well-being in a rapidly shifting media environment.</p>