Addiction and Autism

June 11, 2024

Explore the intricate connection between addiction and autism, risk factors, treatment approaches, and coping strategies.

Understanding Substance Use in Autism

When exploring the connection between addiction and autism, it's crucial to understand the patterns and risk factors associated with substance use in individuals with autism spectrum disorders (ASD).

Risk Factors for Substance Use in Autism

Individuals with ASD have a doubled risk of encountering substance use-related problems, and this risk is even higher among those with comorbid attention deficit hyperactivity disorder (ADHD) as per PubMed. Even ASD patients without diagnosed comorbidity of ADHD or intellectual disability (ID) still have a significantly increased risk of substance use-related problems.

Interestingly, it's not just individuals with ASD who are at risk. Full siblings and parents of individuals with ASD also have an increased risk for substance use-related problems, highlighting that shared familial factors, including genetic and/or shared environmental factors, may contribute to the increased risk of substance use-related problems in individuals with ASD.

Risk Group	Increased Risk
Individuals with ASD	Double
Individuals with ASD & ADHD	Higher than double
ASD patients without ADHD or ID	Significantly increased
Full siblings & parents of individuals with ASD	Increased

People with autism who have average or above-average intelligence quotients (IQs) are more than twice as likely to become addicted to alcohol or other drugs as their peers are. The risk is even higher for people who also have attention deficit hyperactivity disorder (ADHD) as per The Atlantic.

Substance Use Patterns in Autistic Individuals

Contrary to traditional beliefs that substance use-related problems are rare in individuals with ASD, recent research suggests that it's more common than previously thought. Autistic individuals are more likely to report using substances to manage behavior, such as using recreational substances to manage autism symptoms. They also report using substances to manage mental health symptoms according to NCBI.

Moreover, autistic individuals are more likely to report vulnerability associated with substance use, including childhood use of drugs and being forced or tricked into using drugs. They are more likely than non-autistic individuals to report an atypical response to drugs and to report experiences of substance use that indicate vulnerability.

The combined prevalence of alcoholism and addiction in people with autism ranged from 0.7 percent to 36 percent, with most studies suggesting a significantly lower prevalence than in the general population. In the United States, the lifetime prevalence of alcoholism is 14 percent and for other substance addictions, the figure hovers around 2 to 3 percent according to The Atlantic.

Understanding these risk factors and patterns of substance use can guide the development of effective interventions and support for autistic individuals who struggle with substance use. It's crucial to continue studying and addressing this complex issue to improve the lives of those affected by addiction and autism.

The Link Between Autism and Addiction

Exploring the connection between autism and addiction involves understanding the underlying genetic and environmental factors that may predispose individuals with autism to substance use disorders. It also requires a look into the neurochemical connections that may be shared by both conditions.

Genetic and Environmental Factors

Research has suggested that shared familial factors, encompassing both genetic and shared environmental elements, could contribute to the increased risk of substance use-related problems in individuals with Autism Spectrum Disorder (ASD) PubMed. Certain genes implicated in autism, such as NLGN3 and chromosomal region 16p11.2, are also involved in addiction, indicating a possible genetic link The Atlantic.

Furthermore, studies have shown that parents and siblings of individuals with autism have a higher risk of addiction, reinforcing the idea of a possible genetic connection The Atlantic.

Group	Risk of Addiction
People with Autism	Doubled
Autism with IQ > 100	Elevated
Autism with intellectual disability and ADHD	Fourfold
Autism with IQ > 100 and ADHD	Eightfold

Data Source: The Atlantic

Neurochemical Connections

In addition to the genetic and environmental factors, there are neurochemical connections between autism and addiction that may contribute to the link between these two conditions. Neurochemicals such as oxytocin, dopamine, and the brain’s natural opioids in the striatum may play a role in both autism and addiction The Atlantic.

Understanding these connections could provide valuable insights into the complex relationship between autism and addiction. It may also help in the development of effective treatments and interventions for individuals who are dealing with both conditions.

In summary, the connection between autism and addiction seems to be multifaceted, involving genetic, environmental, and neurochemical factors. Further research is needed to fully understand these connections and their implications for the treatment and support of individuals with autism and addiction.

Challenges and Vulnerabilities

Understanding the association between addiction and autism requires a deep dive into the unique challenges and vulnerabilities faced by individuals on the autism spectrum. These individuals often report atypical responses to drugs and present unique vulnerability factors associated with substance use.

Atypical Responses to Drugs

Autistic individuals are more likely to report an atypical response to drugs, which can manifest in unique experiences of substance use. This atypical response can vary greatly among individuals, making it a complex aspect of the addiction and autism connection to understand and address.

Moreover, research suggests that autistic individuals are more prone to using recreational drugs, such as marijuana, cocaine, and amphetamines, to manage unwanted symptoms, including those related to their autism. These individuals were found to be nearly nine times more likely than non-autistic peers to report using drugs for self-medication purposes [2].

Vulnerability Factors

Autistic individuals are more likely to report vulnerability associated with substance use, including childhood use of drugs and instances of being forced or tricked into using drugs. This vulnerability can lead to a higher risk of addiction and other adverse outcomes associated with substance use.

Furthermore, individuals on the autism spectrum are over four times more likely to report vulnerability associated with substance use compared to their non-autistic peers. This includes dependence or addiction, using drugs to cope with past trauma, and substance use associated with suicidal ideation.

Autistic adolescents and adults were also over three times more likely than others to report using substances to manage mental health symptoms, including anxiety, depression, and suicidal thoughts. The self-medication of drugs was often used as a means to reduce the doses of prescribed medications for mental health conditions [3].

These findings highlight the significant challenges and vulnerabilities faced by autistic individuals in relation to substance use. It underscores the need for tailored interventions and support strategies to address the unique needs and experiences of this population in the context of addiction and substance use.

Treatment Approaches for Autism and Substance Use

Addressing substance use in individuals with autism requires a unique approach that takes into account their specific needs and challenges. Two promising strategies include Cognitive Behavioral Therapy (CBT) and individualized therapy and support.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a psychotherapy approach that helps individuals understand how their thoughts and feelings influence their behaviors. This therapy is often used to treat a variety of mental health disorders, including substance use disorders (SUD).

When modified for autism spectrum disorder (ASD), CBT may represent a promising treatment option for individuals with ASD and SUD. In a study, this treatment resulted in some improvement in three out of four participants who completed the treatment [4].

This form of therapy can be adapted to address the specific needs of individuals with ASD, including the use of more direct communication, additional sessions, and comprehensive support in various aspects of their lives. This includes psychoeducation on ASD, social training, and help with organizing various aspects of their lives.

Individualized Therapy and Support

Individualized therapy and support are crucial when treating addiction and autism. This approach takes into account the unique challenges and needs of each individual with ASD, and adapts the treatment accordingly.

Research suggests that group treatment can also be effective for patients with ASD and SUD. After completing group intervention, patients reported lower levels of alcohol use, craving, passive coping styles, depression, anxiety, and stress symptoms. The effects were even stronger at the 3-months follow-up.

However, it's important to note that some individuals with ASD may find traditional therapies and treatment programs, especially group-based ones, difficult due to the social interaction required. Ideally, all treatments and therapies should be delivered by a professional with an understanding of autism.

Despite the potential effectiveness of these treatment approaches, autism-specific support for addiction is not very common. Most people will be referred to general addiction services, highlighting the need for more tailored, ASD-specific addiction treatment options. Regardless, it is crucial that support is adapted to a person's specific needs to ensure the best possible outcomes [6].

Impact of Substance Use Disorders in Autism

Substance use disorders (SUDs) have been assumed to be rare in individuals with autism spectrum disorder (ASD), but recent research suggests that the rates of SUD among individuals with ASD may be higher than assumed [4]. The prevalence of SUDs in individuals with ASD appears to be higher than previously described (Source), which brings to light the impact of these disorders on the quality of life and the negative consequences for individuals with ASD.

Quality of Life Implications

Substance use disorders have a negative impact on the quality of life for individuals with ASD. They are responsible for a high rate of accidents, mental health problems, premature death, violence, and suicide attempts. Substance use dysregulates daily routines and triggers further substance use, leading to a vicious cycle. The disruption to daily life and the mental strain can be a significant barrier to the individual's overall well-being and their ability to function in society.

Negative Consequences

The consequences of substance use disorders in individuals with autism are far-reaching and can be severe. The combined prevalence of alcoholism and addiction in people with autism ranged from 0.7 percent to 36 percent, with most studies suggesting a significantly lower prevalence than in the general population. In the United States, the lifetime prevalence of alcoholism is 14 percent and for other substance addictions, the figure hovers around 2 to 3 percent.

However, an autism diagnosis doubles the risk of addiction, with elevated risk concentrated among those with an IQ of 100 or above. Among those with autism and intellectual disability, having ADHD increases the risk of addiction fourfold; among those with an IQ in the typical range or above, ADHD increases the risk eightfold.

The negative consequences also extend to the families and communities of individuals with ASD. The stress and emotional burden can strain family relationships and lead to social isolation. Additionally, the societal costs, such as medical expenses and lost productivity, can be substantial.

In conclusion, the connection between addiction and autism is complex and multifaceted, and it's critical to increase awareness and understanding of this issue. By doing so, we can better support individuals with ASD who are struggling with substance use disorders, and work towards improving their quality of life.

Coping Strategies and Support

When it comes to addressing addiction and autism, understanding the coping strategies employed by individuals with autism and the support they need is crucial.

Self-Medication with Substances

Research from the University of Cambridge has shown that autistic individuals are more likely to use recreational drugs, such as marijuana, cocaine, and amphetamines, to manage unwanted symptoms, including autism-related symptoms. In fact, they were nearly nine times more likely than non-autistic peers to report using drugs for self-medication.

Moreover, autistic adolescents and adults were over three times more likely than others to report using substances to manage mental health symptoms, including anxiety, depression, and suicidal thoughts. The self-medication of drugs was used to reduce the doses of prescribed medications for mental health conditions.

Despite these findings, the same study showed that autistic adults were less likely than non-autistic peers to use substances, with only 16% of autistic adults reporting drinking on three or more days per week compared to 22% of non-autistic adults. Similarly, only 4% of autistic adults reported binge-drinking compared to 8% of non-autistic adults.

Substance Usage	Autistic Adults	Non-Autistic Adults
Drinking 3+ days/week	16%	22%
Binge-Drinking	4%	8%

Importance of Individualized Support

The unique experiences of individuals with autism underscore the importance of individualized support in managing substance use. Autistic individuals are over four times more likely to report vulnerability associated with substance use compared to their non-autistic peers, including dependence/addiction, using drugs to deal with past trauma, and substance use associated with suicide.

Furthermore, new areas of vulnerability identified were being forced, tricked, or accidentally taking drugs, and childhood use of substances at the age of 12 years or younger. Given these insights, it is evident that individualized support and intervention strategies are crucial for autistic individuals struggling with substance use.

These findings highlight the complexity of the relationship between addiction and autism. While some individuals with autism may turn to substances as a coping mechanism, others may be at risk due to increased vulnerability. As such, it is crucial to provide tailored support and interventions that address the individual needs and experiences of people with autism.