Substance Abuse In Individuals With Autism
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Substance Abuse In Individuals With Autism

Dr. Alan Weiner MD

Medically reviewed by

Dr. Alan Weiner, MD

February 11, 2019

People with autism may use drugs or alcohol to ease social interaction, raising their risk of developing a substance use disorder. Addiction treatment for individuals with autism should be sensitive to their unique needs.

Autism affects one in 59 children in the United States, reports the Centers for Disease Control and Prevention (CDC). As these children grow up, they are likely to experience social difficulties and may struggle with other mental disorders such as Attention-Deficit Hyperactivity Disorder (ADHD), anxiety, and addiction.

In 2013, the term Autism Spectrum Disorder (ASD) was given to several different severities of autism, including autistic disorder and Asperger syndrome. ASD can manifest in different ways, but generally stunts a person’s ability to behave or interact in a socially acceptable manner.

A person with this disorder may:

  • have difficulty engaging in conversation
  • speak in a monotone (without emotion)
  • not pick up on social cues
  • adhere to rules even when irrational
  • engage in repetitive behavior
  • avoid eye contact

Antisocial tendencies and rigid obedience to rules can prevent many people with autism from being in situations where substance abuse occurs. Because of this, many researchers concluded in the past that people with autism were less also likely to develop a substance use disorder.

However, while autistic people are less likely to abuse substances, those who do are more likely to experience related problems. A 2016 study found that people with autism had twice the risk of developing a substance use disorder than those without ASD. People with both ASD and ADHD had an even higher risk.

Many people with autism suffer from other mental issues, such as anxiety, obsession, and depression, notes the Journal of Alcoholism and Drug Dependence. Excessive stress and the inability to healthily deal with it often leads people to substance abuse.

One common reason an autistic person may misuse alcohol or drugs is to lower their inhibitions and ease social interactions. Participating in substance use with others may not only help a person with ASD relax, but it can also be a way for them to fit in.

If drinking or doing drugs is the only way a person with autism feels comfortable with others, they are likely to develop an addiction. This mental dependence on substances in order to feel normal may also come with physical dependence, which can produce painful withdrawal symptoms if a person stops taking drugs or drinking alcohol.

Long-term substance abuse can have many negative effects on the body and brain. It may even worsen symptoms associated with autism, as addiction can lead to antisocial behavior, paranoia, psychosis, and cognitive impairment.

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Autism And Addiction In The Brain

Autism and addiction affect the brain chemical dopamine, which is responsible for producing a sense of reward. Stimulant drugs, like cocaine and amphetamines, cause a surge in dopamine that gives someone a burst of energy. Depressant drugs, like heroin and other opioids, raise dopamine levels for a euphoric sensation.

A recent study on the co-occurrence of addiction and autism suggests that people who develop addictions have fewer dopamine receptors, and thus experience less reward from everyday pleasures. This causes them to seek the reward through other means, such as using substances to boost their brain’s dopamine production.

With many drugs, prolonged abuse leads the brain to produce less natural dopamine. This forms a reward system (or addiction) that requires a person to continue using a substance in order to feel the positive outcome.

Conversely, people with autism may experience too much dopamine at times. They can have a hypersensitivity to some things, which causes over-stimulation. In response, an autistic person may develop an intense interest in certain things and remain interested much longer than the average person. This “preoccupation” is helpful in regulating anxiety because focusing on something productive reduces dopamine levels and helps them feel calm.

There may be similarities in behavior between people with autism and people struggling with substance abuse. The preoccupation with drug-seeking that plagues many people with substance use disorders reflects the obsessive tendencies of autism.

Other similarities between a person with ASD and a person under the influence of drugs or alcohol may be:

  • Anti-social Behavior
  • Difficulty Communication
  • Repetitive Actions

These similarities may lead some people with autism to feel more comfortable among people using substances. There are likely fewer social expectations in this group and the similar behaviors may relieve the pressure for an autistic person to act a certain way.

Treating Substance Use Disorders In Individuals With Autism

Most addiction treatment programs integrate group therapy, counseling, or support groups into a recovery plan. This may not be effective for people with Autism Spectrum Disorder (ASD), as certain social settings already pose difficulties for them in everyday life.

A person must participate in treatment in order to be successful. The stress surrounding social participation for a person with ASD can be debilitating. They may be unwilling or unable to communicate with others, which may hinder communication among the group in general.

Requiring an autistic person to be part of a group in which they are not comfortable may make them angry or anxious, and can cause them to drop out of treatment altogether. The best treatment programs are customized to individual needs and ability to address these issues in a more productive way.

Many inpatient rehab centers offer dual diagnosis treatment. This is essential when someone suffers from co-occurring disorders (addiction and another mental disorder, like autism). Dual diagnosis treatment works through both mental issues, dealing with the root of the problem to promote complete healing and reduce the chance of relapse.

For people dealing with autism and a co-occurring substance use disorder, the following treatment types may be beneficial:

  • Behavioral Therapy – helps people think and act more appropriately
  • Social Skills Training – teaches people how to develop positive relationships
  • Speech-Language Therapy – aids people in communicating more effectively
  • Occupational Therapy – prepares people to be productive members of society

Overcoming difficulties associated with autism may prevent a person from turning to substances to take the edge off social interactions. If they have developed an addiction, these therapies can help them overcome it through the development of healthier habits, coping skills, and a good support system.

To learn more about substance abuse and treatment for individuals with autism, contact us at today.

U.S. National Library of Medicine - Increased Risk for Substance Use-Related Problems in Autism Spectrum Disorders: A Population-Based Cohort Study

Journal of Alcoholism & Drug Dependence - Addiction and Autism: A Remarkable Comorbidity?

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