Youth with chronic medical conditions (YCMC) including rheumatic disease use substances and may experience harms from doing so. The chronic illness experience may amplify substance use risks for some YCMC who may use to ameliorate symptoms of disease activity and negative side effects of medications, so-called "instrumental use." This article provides a brief overview of adolescent substance use, its intersection with chronic illness, and pediatric-onset rheumatic disease (PRD). A biopsychosocial model of substance use vulnerability for youth with PRD is presented along with emerging evidence about instrumental use of substances. Implications for PRD clinical practice are discussed.
Keywords: Adolescents; Chronic illness; Instrumental substance use; Self-medication; Substance use.
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