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Drug/Alcohol Abuse: A Comorbidity in Autism Spectrum Disorder?

“I heard that people with ASD use drugs more than the general population. They say because it helps them with their anxiety issues. Is this true?”

Actually, a remarkably low occurrence of drug abuse has been reported in this population [1] (research results involving 122 patients). Additionally, other research [2] stated that teens with high-functioning autism had a fairly low risk of drug abuse. 
 
This may be due to the fact that these young people do not typically display sensation-seeking traits and have an introverted personality in general.

Another study [3] showed higher rates of drug abuse in people with ADHD compared with those with an autism spectrum disorder (58 % versus 30 %). However, alcohol abuse may be a different story.

Matthew Tinsley (an adult with high-functioning autism and alcohol dependency) stated in his book that alcohol abuse in this population may be a way for them “to cope with their anxiety, to maintain friendships, to give access to a whole host of relationships, and even to sustain careers” [4]. Adults on the autism spectrum may display a ‘normal’ façade when they drink, which might explain why their alcohol abuse is not better diagnosed.



On a neuropsychological level, alcohol abuse (which is probably underestimated in this population) may be connected with the “Aspies” social skills deficits (e.g., difficulty empathizing with others, and impaired ability to recognize the emotions of others) [5].

In addition to anxiety (which is typical of Asperger’s and high functioning autism), the main traits are:
  • a weak central coherence (i.e., an inability to bring together various details from perception to make a meaningful whole),
  • social cognition impairments (i.e., an inability to process, store, and apply information about other people in social situations),
  • and executive dysfunction (i.e., deficits in the higher-order processes that enable us to plan, sequence, initiate, and sustain our behavior towards some goal, incorporating feedback and making adjustments along the way) [6]. 




 COMMENTS:

•    Anonymous said… Being ASD or ADHD does increase your chances of using alcohol and or drugs. Also increases the chance of having suicidal thoughts. Lots of things for us to watch out for as our kiddos get older...
•    Anonymous said… Cannabis have helped me (for 30 years). Alcohool no.
•    Anonymous said… For me I disagree. Ian very much anti drugs
•    Anonymous said… For some yes. I don't abuse alcohol but drinking in a social situation makes a world of difference for me (a BBQ or hanging around the house with a friend, acceptable drinking situations  đŸ€·‍♀️). I am however a VERY heavy smoker and have used it as a coping mechanism for years.
•    Anonymous said… Have Aspergers and ADHD, had to stop drinking lately as I've been worried about the amount. Definitely helps when I go out if I have drinks but it can get out of hand.
•    Anonymous said… Hell yes for me it was. I drank like a fish to deal with humans. It covered up social anxiety and made humans more palatable and easier to understand.
•    Anonymous said… I had to stop drinking and smoking because I used to be a drug addict and was addicted to cannabis by 15 I was diagnosed at 20. I have a very addictive nature and I still 2 years later I still get urges to smoke and drink. But i would neber touch drugs again. I've had no help from organisations or counciling. I over came it all alone. I how ever very much believe in medical uses for cannabis and other drugs for the help of mental health issues and cancers. I won't even take medicines now due to my past addictions. I do everything herbally or dietary now.
•    Anonymous said… I had to stop drinking due to health issues and that is what lead me to discovering my place on the spectrum. I had no idea how much I was using alcohol as a coping mechanism for my social anxiety. I'm a musician and I stopped performing all together because I couldn't handle being around people. It not only eliminates my anxiety but it makes me more interactive. Without it I'm sitting in the corner pinching the crap out of pressure points and avoiding eye contact.
•    Anonymous said… I have never drank, smoked or taken a illegal drug in my life and pretty sure I never will.
•    Anonymous said… I never drank more than a sip at thanksgiving a few times, never done any illegal drugs. I have smoked 6 cigars and 1 gasping puff off a Marlboro red. And I accidentally got drunk as a skunk at 9 on chocolate rum balls my dad made and told me to stay out of..... couldn't comprehend what alcohol was at the time and I love chocolate. Which brings me to my only real addiction.... chocolate. I'm a bonafide chocoholic. Like dayyyymmn if there is chocolate in the house, no matter what quantity.... I have no willpower to resist it. When I was younger, my mom bought chocolate bars and stuck them in the freezer thinking I would not eat them frozen...... wrong. I ate them frozen. My only way of dealing with this is to use what will power I have while shopping. I bar a week.
•    Anonymous said… In my case, no. I avoid anything that alters my ability to think clearly and accurately, because I always want to be at my best and I understand that there is a lot I can do personally to maintain holistic health.
•    Anonymous said… I've never drank, smoked or taken illegal drugs and never want to ever
•    Anonymous said… Most of the time it makes my symptoms worse so no. However I do consider myself a psychedelic artist, and I am in a scene where drugs are plentiful. For me however my main inspiration comes from my experience living with autism and naturally being psychedelic from birth. I always saw things and felt things that no one else did or could relate to at all. I have lived a very introverted and isolated life. I did find a scene that embraced me and my art, so what I do is help those on psychedelics or on spiritual paths to facilitate their journey with my art by live painting and performing at events. It is my passion and gives me a purpose that is true to my core being as an aspie artist.
•    Anonymous said… My autistic friend loves to smoke cannabis multiple times a day. He says it makes life worth living.
•    Anonymous said… No, I have never drank, smoked, or abused drugs. However I do have a eating disorder and I self harmed in the past.
•    Anonymous said… No. I take caffeine from coffee or tea(lipton) only, which is natural. Helps my co-ordination in studies, and conversation. Am okay with that. Don't want any drug. I love me like that.
•    Anonymous said… Not all substances are equal. Some drugs affect the mind; some affect the body. Rather than exploring something as ridiculous as whether usage statistics are in line with what’s “normal”, I’d be more interested to know what substances appeal to people on the spectrum.
•    Anonymous said… Nothing wrong with me..I just need a drink?
•    Anonymous said… They do try to self medicate
•    Anonymous said… True for me. I developed a huge drink problem due to using it to alleviate social anxiety.
I'm ok now since I gave up my career.
•    Anonymous said… True here, or it used to be.... alcohol is my best friend and my worst enemy. It's slowly killing me but I wouldn't want to live without it  😔
•    Anonymous said… Yep- makes you feel "normal" and social, reduces sensory overload, and quiets ruminating in the brain. It alleviates the "raw" feeling I have almost all the time as an Aspie. Huge struggle.
•    Anonymous said… Yep...it was there all along!.. Now ya making progress!
•    Anonymous said… Yes. Working in a bar, things are loud and overstimulating, plus fitting in and being social is difficult and exhausting.
•    Anonymous said… Yup. Makes social interaction easier. Also, at an early age allowed me to form closer bonds with others. I don't abuse it either since i'm aware it can be crutch. It can be a tool if used wisely and with caution -- sometimes easier said than done. Not encouraging alcohol use by any means.

Post your comment below…
 
 
 
References—
  1. Hofvander B, Delorme R, Chaste P, NydĂ©n A, Wentz E, StĂ„hlberg O, Herbrecht E, Stopin A, AnckarsĂ€ter H, Gillberg C, RĂ„stam M, Leboyer M. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry. 2009;10:9–35.
  2. Ramos M, Boada L, Moreno C, Llorente C, Romo J, Parellada M. Attitude and risk of substance use in adolescents diagnosed with Asperger syndrome. Drug Alcohol Depend. 2013;133(2):535–540. doi: 10.1016/j.drugalcdep.2013.07.022. 
  3. Sizoo B, van den Brink W, Koeter M, van Gorissen Eenige M, van Wijngaarden-Cremers P, van der Gaag RJ. Treatment seeking adults with autism or ADHD and co-morbid substance use disorder: prevalence, risk factors and functional disability. Drug Alcohol Depend. 2010;107(1):44–50. doi: 10.1016/j.drugalcdep.2009.09.003. 
  4. Tinsley M, Hendrickx S. Asperger Syndrome and Alcohol: Drinking to Cope? In: Jessica Kingsley Publishers, editor. London; 2008. p. 9.
  5. Thoma P, Friedmann C, Suchan B. Empathy and social problem solving in alcohol dependence, mood disorders and selected personality disorders. Neurosci Biobehav Rev. 2013;37(3):448–470. doi: 10.1016/j.neubiorev.2013.01.024. 
  6. Baron-Cohen S, Wheelwright S, Robinson J, Woodbury-Smith M. The Adult Asperger Assessment (AAA): a diagnostic method. J Autism Dev Disord. 2005;35(6):807–819. doi: 10.1007/s10803-005-0026-5.

Asperger's Traits That Get Misinterpreted As "Inappropriate" Behavior



There is usually some distress, anxiety, or obsession manifested in most “inappropriate” behaviors that gets misinterpreted by others:

Misinterpretation #1 - A "low tolerance for boredom" disguised as laziness

Misinterpretation #2 - The inability to "read" others disguised as lack of empathy

Misinterpretation #3 - Poor "emotion regulation" disguised as psychological instability

Misinterpretation #4 - Detachment disguised as narcissism

Misinterpretation #5 - Social skills deficits disguised as abnormality

Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

==> Cassandra Syndrome Recovery for NT Wives

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

==> Want more information on your partner's traits and how they affect relationships? Here you go..... 

Men with ASD [level 1]: Summary of Traits that Affect Relationships

Peculiar people have always been around, but ASD [Asperger's] - also called high-functioning autism - isn't always recognized as a possible cause of odd behavior. The symptoms of AS can be mild (causing only somewhat unusual behavior), or severe (causing an inability to function in society without assistance).

For the "neurotypical" (i.e., non-autistic) women out there who are contemplating developing a relationship with a male on the autism spectrum - or for those who are already in such a relationship - below is a summary of the traits associated with the disorder that may be helpful in understanding your future boyfriend or husband.



Men with ASD:

1. have trouble deciphering the normal rules of society, which impacts their home, work and social lives

2. are often unable to understand other people's emotional states

3. often want to "fit in" with their peer group - but don't know how

4. think in "black and white" terms

5. tend to be in their own world

==> Living With Aspergers: Help for Couples

6. appear overly concerned with their own agenda

7. have difficulty managing appropriate social conduct and regulating emotions

8. follow strict routines

9. are highly focused in specific fields of interest often to the exclusion of other pursuits

10. have trouble empathizing and understand other perspectives

11. appear aloof, selfish or uncaring

12. have difficulties in their home life, often demanding little or no change in routines or schedules

13. behave at a younger developmental age in relationships

14. have difficulty understanding humor and may take what's said too literally
 
15. have obsessive tendencies (e.g., insisting all of their books be lined up in a certain order on the shelf or that the clothes in their closet are categorized by color, style or season)

16. lack the ability to display appropriate non-verbal behaviors, such as eye contact, facial expressions, body postures and gestures

17. have difficulties in initiating and maintaining friendships because of inappropriate social behaviors

18. tend to be literal thinkers

19. have trouble understanding social metaphors, teasing or irony

20. struggle to understand emotions in others

==> Living With Aspergers: Help for Couples

21. miss subtle cues such as facial expression, eye contact and body language

22. often avoid eye contact

23. may be unable to think in abstract ways

24. are preoccupied with something to the extreme level (e.g., if they like football, that is all they will talk about--all the time and with everyone)

25. may talk incessantly, often about topics that others have no interest in

26. are rigid and inflexible, making transitions of any type difficult

27. lack the social or empathetic skills to effectively manage romantic relationships

28. are often of high intelligence and may specialize in one area or interest, which leads to a lack of interest in alternate topics and the unwillingness to listen when others are speaking

29. need routines to help them function

30. experience poor communication skills which can lead to problems finding a job or interacting effectively in a workplace environment





31. are reliant on routine

32. have an obsession with categories and patterns

33. experience rigid thinking patterns that may make predicting outcomes of situations difficult

34. may have anger management problems and may lash out in a social setting without regard to another's feelings

35. may display highly developed vocabulary, often sounding overly formal and stilted

36. experience speech patterns that may have a strange cadence or lack the proper inflections

37. often memorize facts to the smallest detail

38. find the subtleties of courtship difficult

39. experience social and work-related difficulties which can cause anxiety, anger, low self-esteem, obsessive compulsive behaviors, and depression

40. have thought patterns that may be scattered and difficult for the listener to follow

==> Living With Aspergers: Help for Couples

41. are often obsessed with parts of objects

42. are often physically awkward and have a peculiar walk, poor posture, general clumsiness, or difficulty with physical tasks

43. may appear rude or obnoxious to others

44. can be inflexible in their thinking, unable to imagine a different outcome to a given situation than the one they perceive




45. may be reluctant to initiate conversation and may require prodding to talk

46. often choose inappropriate topics to discuss in a group setting or find making small talk difficult or even annoying

47. may demonstrate unusual non-verbal communication, such as limited facial expressions or awkward body posturing

48. develop strict lifestyle routines and experience anxiety and distress if that routine is disrupted

49. often engage in one-sided conversations without regard to whether anyone is listening to them

50. may feel disconnected and distant from the rest of the world, a feeling called "wrong planet" syndrome

51. may flap their hands or fingers, or make complex body movements

52. have difficulty interacting in social groups

53. have trouble with organization and seeing the "big picture," often focusing on one aspect of a project or task

54. may process information more slowly than normal, making it difficult to participate in discussions or activities that require quick thinking

55. may keep extensive written to-do lists or keep a mental checklist of their plans

Some may view the traits above as largely negative. Others may view them as simply a different way of viewing - and interacting with - the world. More on this topic can be found here ==> Aspergers: Disability or Unique Ability?




Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

==> Cassandra Syndrome Recovery for NT Wives

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

Understanding the Mind of Your Partner with ASD

"I'm currently dating a guy who is diagnosed with Asperger’s. I don't know much about this condition. How can I understand the way he thinks? We are definitely not on the same page most of the time. I need to know more about this and how it could affect our relationship."

There are several traits associated with ASD (high-functioning autism, or Aspergers) that can have an effect on how the relationship develops (not all negative, of course). People with the disorder typically have underdeveloped areas in the brain that cause problems in communication, focusing on “the real world” as opposed to becoming absorbed in their own thoughts and obsessions, learning appropriate social skills and responses, and understanding the thoughts and feelings of others.

They are often extremely literal in their interpretation of others’ conversations, and have difficulty recognizing differences in speech tone, pitch, and accent that alter the meaning of what others’ say (e.g., they may not understand a joke or may take a sarcastic comment literally).





For some people on the spectrum, learning social skills is like learning a foreign language. They may have difficulty reading non-verbal communication that “typical” people learn without formal instruction (e.g., not understanding the appropriate distance to stand from another person when talking, how to tell when someone does not want to listen any longer, how to interpret facial expressions, etc.).



These individuals are usually highly aware of right and wrong - and will bluntly announce what is wrong. They tend to recognize others’ shortcomings, but not their own. Thus, they may come across as insensitive, selfish, or rude.

They tend to need routine and predictability, which gives them a sense of safety. Change often causes stress, and too much change can lead to a meltdown or shutdown. Changes that are stressful for them may include (a) starting a new routine (e.g., having to go a different route to work due to construction), (b) having a different supervisor at work, (c) having to do things in a different order, or (d) major changes to their environment (e.g., when a wife rearranges the furniture without consulting the Asperger's husband first).

==> Living With Aspergers: Help for Couples

Routines and predictability help them remain calm. Your boyfriend's thinking is likely to be totally focused on only one or two interests, about which he is very knowledgeable. Many people on the autism spectrum are interested in parts of a whole (e.g., space craft, computers, insects, drawing highly detailed scenes, designing houses, astronomy, and so on). Your boyfriend's brain is likely to be obsessed by his interest. Thus, he may talk only about it, even when others are carrying on a conversation on a different topic.

People with ASD tend to notice details rather than the “whole” picture. The importance of the detail prevents them from understanding the bigger picture, so instructions may get lost in their focus on a single detail. Also, multiple instructions are extremely difficult for these individuals to retain and follow.

They are not able to access their frontal cortex or prefrontal lobe efficiently, so they must call on social skills from their memories. If a particular social skill has not been taught to them as a child, they won’t have it as an adult.

Therefore, imagination, conversation, and other people’s points of view cause them great difficulty. They may be unable to realize consequences outside their way of thinking. Also, they may not be able to recognize when someone is lying to them or trying to take advantage of them.

Frustration and resultant anger often occurs due to over-stimulation of the senses or a change in routine. It is often the only response they know. Difficulty with anger-control can present problems in relationships. They tend to view things in black and white terms, which may result in angry outbursts when they don’t get their way, or when they feel threatened or overwhelmed.

Some people with ASD bottle-up anger and turn it inward in the form of depression, never revealing where the problem is. Many are perfectionists, reacting with anger when things don’t go the way they had hoped.

One of the most difficult thinking patterns of people with Asperger's is mind-blindness, which is the lack of ability to understand the emotions, feelings, motivations and logic of others. Unfortunately, some of these individuals don't care that they don’t understand! Thus, they may behave without regard to the welfare of others. Many will only change their thinking or behavior if it is in their own interest to do so. Even then, convincing the person with ASD to change his mind may be an uphill battle.




Resources for Neurodiverse Couples:

==> Online Group Therapy for Men with ASD

==> Online Group Therapy for NT Wives

==> Living with ASD: eBook and Audio Instruction for Neurodiverse Couples 

==> One-on-One Counseling for Struggling Individuals & Couples Affected by ASD

==> Online Group Therapy for Couples Affected by Autism Spectrum Disorder

==> Cassandra Syndrome Recovery for NT Wives

==> ASD Men's MasterClass: Social-Skills Training and Emotional-Literacy Development

==> Click here for more information on how your partner with Asperger's or high-functioning autism thinks...

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