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y associated with substance use (OR 4·16, 1·90-10·05; p=0·00027), including childhood use of drugs and being forced or tricked into using drugs. Autistic individuals might be less likely than non-autistic individuals to report engaging in substance misuse. They also report using drugs to self-medicate. Clinicians should be aware of vulnerability linked to substance use among autistic patients and should work cooperatively with patients to effectively manage autistic and comorbid symptoms. Autism Research Trust, Rosetrees Trust, Cambridg