Autism and Addiction: Understanding the Connection

For years there’s been a misconception that those with autism were less likely to develop addictions. However, research is increasingly suggesting that autistic people can experience substance use disorders and addictions like everyone else, albeit for reasons that differ from the general population.

Below, we’re looking at the unique relationship between autism and addiction, including risk factors, warning signs, treatment options, and recovery support.

What Is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) is the medical term for a diagnosis of autism. It is a neurodevelopmental condition that affects how people experience and interact with the world. The National Autistic Society describes autism as a lifelong neurodivergence and disability that can present in many different ways, including:

• Differences in social communication
• Sensory sensitivities
• Repetitive behaviours
• Strong interests and routines
• A preference for predictability

Autism is a spectrum, so it should be remembered that experiences vary significantly between individuals.

Can People With Autism Develop Addictions?

Autistic people can develop both substance-related and behavioural addictions just like anyone else, but the underlying drivers and experiences behind them may differ. Unfortunately, addiction in those with ASD can sometimes go unrecognised due to overlapping symptoms or assumptions about risk.

What Does Research Say About Autism and Addiction?

The National Autistic Society says it’s not currently known if autistic people are more likely to experience addiction than non-autistic people, as there are consistently different kinds of addiction and research ongoing.
However, some studies suggest there may be a tendency among some autistic people to attempt to self-medicate through substance misuse. Autistic people may also be less likely to report any substance misuse.

There may be added risks of behavioural addictions such as gambling, gaming and internet addictions, particularly where co-occurring mental health conditions are present.

Research has certainly challenged previous assumptions that autism protects against addiction but risk can vary widely between individuals.

Why Might Some Autistic People Be More Vulnerable to Addiction?

Substances or addictive behaviours may sometimes be used as coping mechanisms or as an attempt to self-medicate. Those with late diagnoses or who lack support often develop unhealthy coping strategies to help them in the neurotypical world.

Some risk factors that may be associated with autism spectrum disorder and addiction could include:

• Anxiety
• Depression
• Social isolation
• Bullying
• Trauma
• Chronic stress
• Difficulties fitting into social environments

The Role of Mental Health Conditions

Co-occurring mental health conditions such as anxiety disorders, depression, and obsessive-compulsive disorder (OCD) can also increase addiction risk, as can other neurodevelopmental conditions such as attention deficit hyperactivity disorder (ADHD). This is the case for autistic and non-autistic people, but those with autism can be more likely to experience mental health issues.

Alcohol and Autism

Some autistic individuals may use alcohol to reduce social anxiety, feel more comfortable in social situations, cope with stress and manage emotional distress. Using alcohol as a coping mechanism can lead to heavy or habitual use, which may contribute to a link between autism and alcohol addiction

Drug Use and Autism

Similarly, some people with autism may turn to recreational or prescription drugs in a bid to manage anxiety or escape sensory overload, as well as coping with social situations. This is generally counter-productive in the long run and can increase risks including addiction, side effects and overdose.

Behavioural Addictions and Autism

There are a number of non-substance-related behavioural addictions that may affect autistic individuals, such as gaming, shopping, gambling and internet addictions.
Focused interests and repetitive behaviours may sometimes overlap with problematic behavioural patterns that can turn into compulsive behaviour and addiction.

Can Sensory Challenges Influence Addiction Risk?

Many people with autism can experience sensory processing differences such as sensory overload, related stress or difficulties managing sensory environments. All of which may contribute to maladaptive coping strategies. Again, though, experiences in this area can vary considerably between individuals and across the autism spectrum.

How Addiction May Present Differently in Autistic Individuals

Addiction symptoms may sometimes look different in individuals with autism. There may, for example, be an increased reliance on routines involving substances or behaviours but individuals may be secretive and adept at masking their coping mechanisms.

For some people, addiction may be accompanied by social withdrawal. In others it may trigger emotional regulation difficulties and changes in established behaviours.

The signs of addiction can sometimes be overlooked or misinterpreted by others, as it may be mistaken for behaviours associated with autism or missed altogether.

Warning Signs of Addiction in Autistic Adults

Despite being more difficult to spot, there may still be some warning signs to look out for, including:

• Increasing substance use
• Loss of control
• Cravings
• Neglecting responsibilities
• Financial difficulties
• Relationship problems
• Escalating behavioural addictions
• Continued engagement despite harm

It’s important to consider changes from an individual’s typical baseline as they may already have some issues such as difficulties maintaining relationships.

Challenges Autistic People May Face When Seeking Help

When seeking help, some people with autism may experience barriers to accessing treatment including:

• Communication differences
• Difficulties with group settings
• Fear of judgement
• Anxiety about unfamiliar environments

Some addiction recovery professionals may also have a limited understanding of the additional issues faced by those with autism; however, tailored support is available that can improve both engagement and outcomes.

How Addiction Treatment Can Be Adapted for Autistic Individuals

A tailored addiction treatment programme should be just that – tailored to the individual and their own unique circumstances.

Person-centred care is hugely important, but there are some elements that could help many people with autism in seeking effective treatment for addiction. These could include ensuring clear communication with structured treatment plans and predictable routines. Sensory and social issues should be taken into account, with therapy approaches adapted to the individual and flexible support options in place.

The Importance of Family and Support Networks

Family members and other loved ones can contribute to the recovery process by providing encouragement, understanding and practical support. Early identification of concerns can be important, but it’s also never too late to seek help.

Can Autistic People Recover From Addiction?

Autistic individuals can certainly achieve a long-lasting recovery, but the process can have additional challenges. Recovery is more likely to succeed when treatment addresses both addiction and the unique support needs through personalised care and support.

When Should You Seek Professional Help?

Some indicators that professional help may be needed include:

• Escalating substance use
• Behavioural addictions becoming unmanageable
• Mental health deterioration
• Failed attempts to stop
• Significant impacts on daily life

If you are concerned about your own or another’s substance misuse or compulsive behaviours, confidential advice and tailored addiction treatment programmes are always available.

The relationship between autism and addiction can be nuanced and complex, so recognising warning signs early and accessing appropriate, autism-informed support can be very important.

If addiction is affecting your wellbeing or that of someone you care about, it’s always best to seek professional help as soon as possible in order to minimise the potential harms.