Alcohol and Autistic Spectrum Disorder
Autism is a neurodevelopmental condition that affects how the brain works. Autism affects the way people experience and interact with the world around them.
Just like anyone else, autistic people can become addicted to alcohol and drugs. Addiction is a challenging disease and can lead to a range of problems for autistic people.
By better understanding autism, we can better support autistic people with addiction.
What is autism?
You might have heard autism referred to as Autistic Spectrum Disorder or ASD. This is because autism affects people in a spectrum of different ways.
People on the autistic spectrum usually:
- Process sensory information differently
- Communicate differently with others
- Interact differently with the world around them
How common is autism?
1 in 100 people are on the Autistic Spectrum.1 We do not yet know what causes autism. We do know that:
- Autism is significantly more common in males 1
- Having a family history of autism increases the likelihood 2
- There is no link between autism and vaccinations
Autism is present from birth and is usually diagnosed in childhood. However, some autistic people might reach adulthood before they receive a diagnosis. A proportion of autistic people may live their lives undiagnosed.
Characteristics of autism
The characteristics of autistic people will vary from person to person.
Autistic children might show the following traits:
- Being easily overwhelmed or upset by sensory stimuli such as loud noises, bright lights, or even tastes and smells
- Making poor eye contact
- Difficulty understanding what others are thinking or feeling
- Difficulty expressing what they are thinking or feeling
- Rigid need for routine
- Preferring to be alone
- Difficulty making friends
- Repeating movements or phrases
- Having restricted and intense interests
Autistic adults might show the following traits:
- Getting upset or stressed if their routine changes
- Difficulty understanding people’s emotions or points of view
- Difficulty following social rules such as making eye contact or not interrupting
- Finding social situations stressful
- Being easily overwhelmed by sensory stimuli
- Having restricted and intense interests
Challenges autistic people might face
The world we live in is designed for the majority of people, often referred to as the “neurotypical” population. This means that the world can present challenges to people who function differently, such as autistic people. Autistic people can face challenges in their relationships, employment, and their day-to-day tasks. The challenges autistic people experience will vary.
Is autism a learning disability?
Autism is sometimes mistakenly called a learning disability. Although it might affect learning in some individuals, autism is not a learning disability. Sometimes, a learning disability might exist alongside autism. Autistic people with learning disabilities often need extra support.
Autism does not determine a person’s intelligence level. Autistic people can have different levels of intelligence. Some autistic people will have a higher than average intelligence.
What is Asperger’s?
Asperger’s was previously used as a subclassification of autism. It was used as a diagnosis for autistic people with certain traits, and typically with above-average intelligence.
In 2013, Asperger’s was removed from diagnostic classifications, including the Diagnostic and Statistical Manual (DSM). Since then, most health professionals have stopped using it as a diagnosis.
Now, people who traditionally met the criteria for Asperger’s, are diagnosed with Autistic Spectrum Disorder instead.
People diagnosed with Asperger’s may choose to continue to use the term Asperger’s, or they may use the term Autistic Spectrum Disorder.
How is autism diagnosed?
If you’re worried that you or your loved one might have autism, the first step is to speak to a general practitioner (GP).
GPs can carry out an initial assessment and decide whether further assessment is necessary. They can then refer you or your loved one to a specialist who can make a diagnosis of autism.
Does autism increase your risk of addiction?
It was previously believed that autistic people were less at risk of developing substance abuse problems. Recent research suggests this is not true. In fact, it’s now thought that autistic people are more at risk of developing a substance use disorder than neurotypicals. 3
Around 11-29% of people with Autistic Spectrum Disorder will develop a substance use problem at some point in their life. 4 It is likely that many factors play a role in determining addiction risk, such as what autistic traits someone has, and gender.5
Why might autistic people develop an addiction?
Autistic people can develop an addiction for the same reasons as anyone else. But there are certain challenges faced by autistic people that might lead to addiction.
Reasons why autistic people may develop an addiction:
- Alcohol and other substances can help quieten thoughts and emotions
Autistic people can sometimes find themselves trapped in a “jumble of thoughts and emotions”. 4 This can be extremely overwhelming and some autistic people turn to alcohol and drugs to help quieten the noise. In the short term, drugs and alcohol may help, but in the long term, they will only worsen the problems. 4
- Alcohol and drugs can temporarily reduce distressing feelings
Autistic people experience the world around them differently than neurotypical people. At times, these differences can lead to frustration or loneliness. In order to temporarily alleviate these feelings, autistic people may turn to alcohol or drugs.
- Alcohol and drugs can give a false sense of confidence in social situations
Some autistic people experience difficulties in certain social situations. They may struggle with poor confidence when it comes to socialising. Alcohol is well known for its temporary relaxing and confidence-boosting effects. Some autistic people use alcohol to help them in social situations. See treatment.
Is it safe for autistic people to drink alcohol?
There is no universal answer to this question. Whether or not it is safe to drink alcohol depends on many factors including physical and mental health.
You should consider reducing or stopping alcohol if:
- You have health problems that alcohol might worsen
- You struggle to keep your intake below the recommended guidelines
- Your alcohol intake leads to increased challenges in your life
The NHS recommends keeping your weekly alcohol intake below 14 units. This figure is the same for both men and women. If you regularly drink 14 units a week, the NHS recommends splitting this intake over at least 3 days. This helps you to avoid excessive alcohol consumption.
Regularly exceeding the recommended guidelines can lead to a range of mental and physical health problems. Alcohol may temporarily alleviate certain problems such as anxiety and low mood, but it will worsen them in the long run.
If you are autistic, you should speak to your medical team to get personalised advice on whether you can safely drink alcohol.
How do you treat addiction in autism?
Autistic people with alcohol or drug addiction can benefit from personalised addiction treatment programmes, with adaptations to suit their individual needs.
In order to provide better treatment outcomes, more research is needed on how substance abuse affects autistic people. 4
Currently, we know that CBT and support networks play a vital role in addiction recovery for autistic people.6
Cognitive Behavioural Therapy (CBT) with autism-informed therapists
CBT is a highly effective form of therapy frequently used in addiction treatment. It has proven useful in treating addictions in autistic people.6
One of the keys to successful therapy is ensuring therapists understand ASD and how it interacts with addiction. Ensuring health professionals have a good understanding of autism could help improve the success of addiction treatment.6
In one study, therapists were given regular training by autism experts. The training taught them about the features of autism, and how to adjust standard therapy sessions to best suit the needs of autistic people. The therapists then worked with autistic people with substance use disorders. Out of the 4 people that completed the therapy programme, 3 either completely stopped or reduced their substance use. All the therapists agreed that understanding ASD was crucial in providing the right treatment for autistic people.6
Involving support networks is key in helping autistic people on their recovery journeys.6 Friends and family can play a valuable role in recovery. Addiction treatment requires a lot of life changes. Supportive family and friends can help autistic people cope with these changes.
Addiction treatment for autistic people at Castle Craig
At Castle Craig, we offer comprehensive and individualised treatment programmes. Our highly experienced team of therapists, psychiatrists, medical staff and addiction workers are here to help support you on your recovery journey.
Our addiction team members are well educated on ASD, allowing them to provide appropriately tailored treatment.
Want to speak to us about treatment for yourself or a loved one? Call us on 01721 722 763.
Get in touch today
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- The Health and Social Care Information Centre. Estimating The Prevalence Of Autism Spectrum Conditions In Adults – Extending The 2007 Adult Psychiatric Morbidity Survey. England: NHS Digital; 2012. Accessed March 15, 2022.
2. Sandin S, Lichtenstein P, Kuja-Halkola R, Larsson H, Hultman CM, Reichenberg A. The familial risk of autism. JAMA. 2014;311(17):1770-1777. doi:10.1001/jama.2014.4144
3. Butwicka A, Långström N, Larsson H, et al. Increased Risk for Substance Use-Related Problems in Autism Spectrum Disorders: A Population-Based Cohort Study. J Autism Dev Disord. 2017;47(1):80-89. doi:10.1007/s10803-016-2914-2
4. Kronenberg LM, Slager-Visscher K, Goossens PJ, van den Brink W, van Achterberg T. Everyday life consequences of substance use in adult patients with a substance use disorder (SUD) and co-occurring attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD): a patient’s perspective. BMC Psychiatry. 2014;14:264. Published 2014 Sep 19. doi:10.1186/s12888-014-0264-1
5. Bowri M, Hull L, Allison C, et al. Demographic and psychological predictors of alcohol use and misuse in autistic adults. Autism. 2021;25(5):1469-1480. doi:10.1177/1362361321992668
6. Helverschou SB, Brunvold AR, Arnevik EA. Treating Patients With Co-occurring Autism Spectrum Disorder and Substance Use Disorder: A Clinical Explorative Study. Subst Abuse. 2019;13:1178221819843291. Published 2019 Apr 17. doi:10.1177/1178221819843291
About the Author
Dr India Duane: Writer for Health and Wellbeing Brands | Medical Doctor living in Scotland. Her extensive medical knowledge and years of experience working with patients and professionals allow her to turn complex medical concepts into readable and interesting content.