title: Alcohol and Marijuana Use and  Treatment Nonadherence Among  Medically Vulnerable Youth.
abstract: OBJECTIVE
  Adolescents 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.
  
  
  METHODS
  Cross-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.
  
  
  RESULTS
  Of 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 non drinking youth, drinkers were 1.79 and 1.61 times as likely to report regularly missing or skipping medications (P values , .05).
  
  
  CONCLUSIONS
  Alcohol 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.
authors.forename: Elissa R
authors.initials: ER
authors.lastname: Weitzman
authors.forename: Rosemary E
authors.initials: RE
authors.lastname: Ziemnik
authors.forename: Quian
authors.initials: Q
authors.lastname: Huang
authors.forename: Sharon
authors.initials: S
authors.lastname: Levy
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012309:Risk-Taking; D016903:Drug Monitoring