Substance Use among Youth with Chronic Medical Conditions

Adolescence is generally associated with health, development and growth. However, a great number of adolescents are affected by chronic illness - defined as a disability interfering with normal life and/or demanding treatment. Substance use often begins in adolescence. It is important to understand the beliefs and attitudes toward substance use among adolescents growing up with a chronic illness.

A recent qualitative study, which involved interviewing young people (16-19) with chronic conditions, has sought to understand factors that contribute to decision-making around substance use. 

Analysis of the interviews uncovered the following 3 themes:

The chronic disease frame 

• Living with and managing their condition shapes the way they define self and experience life. It restricts, complicates and interferes. It is important to be mature and accept the circumstances.
• Constant awareness of how substances would interact with condition/ medication. Restricting substance use in order to retain sensitivity to what their body is telling them.
• Substances were used to relieve pain.

The adolescent stage

• The young people described an appetite for novelty and experimentation. It was important for young people to feel they were making decisions about their life. Being told what to do increased resistance.
• Friends influenced decisions- both in terms of feeling the need to adhere to social norms and learning from other’s mistakes.
• The young people described using substances consciously - making adaptions to treatment regime and finding ways to minimise risk.

Disease-specific substance use knowledge

• It was important for some young people to do research to find out how substance use would interact with interact with condition/ medication.
• Young people preferred hearing factual, honest and disease-specific substance use messages. They appreciated professionals being realistic, confidential, human and understanding with regards to the context of the situation. 

Overall the paper highlights the importance of listening to the perceptions of young people and it provides valuable information to guide preventive interventions with this population.