Individuals on the spectrum are often characterized as rule followers, leading treating professionals to assume that they will not engage in substance use. However, in the past decade we have noticed a substantial increase in the number of adolescents and young adults on the Autism Spectrum who are abusing substances. We will discuss some of the literature that exists on the connection between substance abuse and ASD as well as some reasons why this population is particularly vulnerable to substance misuse and addiction. Through case presentations and discussions, we will provide recommendations for improvement in screenings and assessment as well as some of the limitations of current treatment models.