Autism and Alcohol Addiction

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Specialist Treatment for ASD and Addiction

We provide additional psychiatric care for patients needing support with ASD and addiction.
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Victoria McCann BA, MSc
Page Clinically Reviewed on by Victoria McCann BA, MSc | Communications Director & Editorial Lead

Autistic people are more likely to develop an addiction or substance use disorder than neurotypical people, and there are many reasons why this is the case. In order to provide effective treatment, it is paramount that mental health professionals understand the link between addiction and autism, and feel confident in their ability to adapt therapeutic programmes appropriately. 

What Is Autism?

Autism is a developmental disability which affects how people communicate and interact in the world. It is often referred to as a “spectrum condition”, as it impacts people in different ways and to varying degrees. 1

More than one in 100 people are estimated to be on the autism spectrum, and it is a lifelong condition. Each autistic person will have their own unique experience, but there are often some common shared difficulties. 

According to the National Autistic Society, these include:

  • Finding social communication difficult: it can be hard for some autistic people to interpret other people’s gestures or tone of voice. They may take things literally, find it hard to understand sarcasm or need extra time to process information and answer questions.
  • Finding social interaction difficult: some autistic people find it hard to understand other people, and what they might be feeling. Consequently, they may find it hard to make friends, appear to act strangely in social situations, or need time alone and away from others when it all feels too much.
  • Being sensitive to sensory overload: some people may be extremely sensitive to things like light, sound, light, taste, touch, temperature, and even pain.
  • Experiencing extreme anxiety: many autistic people experience intense anxiety, particularly in social situations or when going through a period of change. 
  • Engaging in repetitive behaviours: often there is a preference for routine, and any changes to this routine can cause additional anxiety. This could mean the person wants to eat the same food for breakfast every day or is unsettled by an event such as Christmas or a change at work.
  • Finding it hard to manage emotions: feeling overwhelmed can result in intense and exhausting experiences for an autistic person. This can sometimes result in the person shutting down and withdrawing, but can also mean a meltdown, where the person loses control and lashes out verbally or physically. 
  • Having a particularly intense mental focus on a specific hobby or interest: this can start at a young age, and may or may not change over time. Autistic people can become experts in a subject, although sometimes this might be to the detriment of other things in their lives.

What Causes Autism?

The causes of autism remain unclear, but evidence suggests that it is genetic, and not caused by emotional deprivation or a person’s upbringing. Research suggests that multiple genes might be responsible, rather than a single one. There is no “cure” as such – autism is a condition that lasts throughout a person’s life.
We know that:

  • Autism is significantly more common in males. 2
  • A family history of autism increases the likelihood. 3
  • Autism is present from birth and is usually diagnosed in childhood. However, some people reach adulthood before they receive a diagnosis. 
  • Many autistic people live their lives without ever being diagnosed. This makes it difficult to ascertain exactly how many people are living with autism.

Does Autism Increase the Risk of Addiction?

It used to be considered that autistic people were less at risk of developing substance abuse problems. However recent research suggests that, on the contrary, autistic people are more at risk of developing a substance use disorder than people who are not autistic. One study showed that autistic people had double the risk of developing an addiction compared to neurotypical people. 4

Other studies have estimated that up to around 30% of autistic people could develop a substance use disorder at some point in their lives. 5,6

What’s more, it has even been suggested that a diagnosis of both autism and substance use disorder increases a person’s mortality risk. 7

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Why Might Autistic People Be More At Risk Of Addiction?

Autistic people may develop an addiction for the same reasons as anyone else. However, those in the autism community also face additional daily challenges which undoubtedly increase their chances of developing an addiction. 

Many would say that living in a world predominantly designed for neurotypical people can be highly stressful. Using substances can become a coping mechanism for some autistic people, to help with managing everyday life. 

Addictive behaviour can help autistic people to function in various ways:

  • Alcohol and other substances can help to quieten thoughts and emotions.

One study found that autistic adults sometimes find themselves caught up in a “jumble of thoughts and emotions”.5

Clearly this can be overwhelming, and some autistic people may turn to alcohol and drugs to dampen down this internal noise. 

  • Alcohol and other substances can give an increased sense of confidence in social situations.

Some autistic people find social situations highly challenging and experience intense anxiety. They may find that using substances helps to reduce this excruciating anxiety, enabling them to function and manage better in social environments.

  • Alcohol and other substances can help a person to mask or hide their autistic qualities.

Many autistic people feel awkward in social situations and try to camouflage their autistic tendencies so that they fit in. However, this masking can lead to exhaustion and mental health issues. 7,8

  • Alcohol and other substances can temporarily reduce distressing feelings.

Autistic people experience the world differently, and at times this can result in intensely uncomfortable feelings, such as frustration and loneliness. To temporarily alleviate distress, some autistic people may turn to substances or other addictive behaviours to numb their pain.

How Do I Know If an Autistic Person Has an Addiction?

Some autistic people have particular hobbies or restricted interests that they like to spend a lot of time doing, but this in itself isn’t considered to be an addiction, even though it may take up a lot of hours. 

To spot signs of addiction, look out for:

  • Work or finances being negatively impacted by a particular behaviour
  • A deterioration in mood or relationships 
  • Not being able to stop doing an activity or behaviour
  • Relying on the activity or behaviour to cope with life

How to Help Autistic People with Addiction Issues 

To provide better treatment outcomes, more research is needed to look at the specific ways in which addiction affects autistic people. 

However, even without further research, we know that autistic people can best be helped by personalised treatment, with addiction programmes carefully adapted to suit their needs.

Plus it has already been shown how cognitive behavioural therapy (CBT) and a strong support network play a major role in achieving recovery.

  • Cognitive Behavioural Therapy (CBT) 

    Cognitive behavioural therapy (CBT) is a highly effective form of talking therapy which is used in general addiction treatment. CBT has also been shown to be beneficial in treating autistic people with addiction, particularly when certain adaptations are made. To this end, the therapy needs to be modified so that it is more structured, direct, and supported with written guidance. In addition, it might also be the case that autistic patients are likely to require more sessions than other client groups. 9

    One of the keys to successful therapy is ensuring therapists understand autism and how it interacts with addiction. Ensuring health professionals have a good understanding of autism is paramount to improving the success of addiction treatment for this patient group.

    In one study, therapists were given 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 autistic people who completed the therapy programme, 3 either completely stopped or reduced their substance use. All the therapists agreed that understanding autism was crucial in providing the right treatment for this group. 9

    As autism affects people differently, treatment interventions need to be carefully tailored for each individual; what works well for one person may not be so effective for someone else. It goes without saying that while people may have the same autism diagnosis, they may have very different therapeutic needs.

  • Support Networks

    Recovery from addiction usually involves significant life changes, and a strong support network can make all the difference in achieving long-term recovery. Involving family and friends in the recovery process will help autistic people cope with these changes and reduce the risk of relapse.

Castle Craig Addiction Treatment 

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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 support you on your recovery journey.

Our skilled addiction specialists understand autism and know how to tailor treatment in the best way. We are fully aware that addiction treatment programmes can feel daunting, particularly if social interaction is required as part of group therapy. Be assured that we will provide the necessary support throughout the process. 

How Is Autism Diagnosed?

If you’re worried that you or a loved one might be autistic, then 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. If required, they can then refer you or your loved one to a specialist for a formal diagnosis.