• Elissa R Weitzman, Rosemary E Ziemnik, Quian Huang, and Sharon Levy.
• Division of Adolescent/Young Adult Medicine, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts elissa.weitzman@childrens.harvard.edu.
• Pediatrics. 2015 Aug 31.

Background And ObjectiveAdolescents face peak risks for onset and intensification of alcohol and marijuana use. However, we know little about these behaviors and their associations with knowledge or treatment adherence among chronically ill youth, a medically vulnerable group.MethodsCross-sectional assessment of consented youth ages 9 to 18 years receiving care for asthma/cystic fibrosis, type 1 diabetes, arthritis, or inflammatory bowel disease (IBD) by using a self-administered online tool. Prevalence and correlates of risk behaviors and associations with knowledge and treatment adherence were estimated using descriptive statistics and logistic regression, controlling for demographics, mental health, and the multiclinic sampling frame.ResultsOf 403 consented youth (75.8% response), 51.6% were girls, 75.1% were white, and average age was 15.6 years. Of high school youth, 36.5% and 12.7% reported past-year alcohol use and binge drinking, respectively; 20% reported past-year marijuana use. Among high school youth, 53.1% and 37.2% answered correctly that alcohol can interfere with their medications and laboratory tests; youth answering incorrectly were 8.53 and 4.46 times more likely to drink and binge drink, respectively (P values < .001). Thirty-two percent and 8.3% of high school youth reported regularly forgetting or skipping their medications in the past 30 days; compared with past-year nondrinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values < .05).ConclusionsAlcohol and marijuana use are common among youth with chronic medical conditions. Alcohol use is associated with treatment nonadherence. Education and preventive interventions are warranted to ameliorate risk.Copyright © 2015 by the American Academy of Pediatrics.

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