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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]. 


•    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… 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…
  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..... 

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