Autism diagnoses have been rising for more than two decades due to increased awareness, testing, and changes to the definition of autism (it’s now a spectrum). Substance abuse rates also have been rising since the start of the COVID-19 pandemic.
There may be a connection between the two disorders, but too little research has even examined the question. A diagnosis of autism may make people more vulnerable to addiction. Up to 85% of the people diagnosed with autism have some form of coexisting mental illness, be it minor or major. These may include anxiety, depression, and mania.
Anxiety and other related conditions are so commonly found in people with autism that there is speculation that there might be a causal link. Forty percent of people with autism spectrum disorders also have anxiety. Comorbid anxiety and autism can cause stress for family members also.
In general, the best treatments for a dual diagnosis of anxiety and autism is cognitive-behavioral therapy (a form of talk therapy) and medication, but these might not be well-advised if there is a co-occurring substance use disorder. With addiction, another approach may be safer and more effective.
The Intersection of Autism and Addiction
While there does seem to be a link between autism and addiction, what it is isn’t exactly clear. Diagnosing autism (and co-occurring addictive behavior) is made more difficult because people on the autism spectrum have difficulty communicating and may be at least partially non-verbal.
We do know that autism is not caused by bad parenting or childhood vaccines, and that substance abuse isn’t caused by moral turpitude.
Autism is a developmental condition that first manifests in childhood (the mean age is just over 5 years old), but substance abuse usually starts in the teens (11 to 17). Autism may be caused by genetic predisposition (it runs in families; if one twin is autistic, the odds for the other are between 36% and 95%) or environmental causes, but no specific genes have been linked to autism exclusively. All are also associated with other types of neurodevelopmental disorders.
Substance use disorders are chronic brain illnesses, with behavioral, environmental, and genetic causes.
The environment can mean exposure to chemicals or other pollutants, but it also means the general physical environment and the psychological environment. Witnessing or experiencing domestic violence or even observing a traffic accident can also be environmental. Such environmental experiences can cause trauma or post-traumatic stress disorder.
People who experience more trauma are more likely to develop substance abuse.
The symptoms of autism can also be traumatic, especially when undiagnosed and untreated. Substance use often starts as an attempt, conscious or not, to self-medicate for the symptoms of a mental health disorder such as anxiety or trauma.
People with autism may be uniquely susceptible to addictive behavior. Routine and repetition are coping mechanisms for autism, but it is also how substance use disorders start. Substance use disorder treatment among people with autism may be more effective with routine-based interventions rather than more common talk therapy.
Even less is known about the co-occurrence of autism and non-substance-based addictions: gambling, gaming, and sex addiction.
Is There a Scientific Link Between Autism and Addiction?
Correlation does not necessarily mean causation. Scientists don’t know if autism can cause substance abuse, but substance use does not seem to cause autism; substance abuse starts later in life than autism. It’s also possible that both autism and addiction share common risk factors.
Take, for example, the possibility that prenatal exposure to some chemical, currently unidentified, has some causative effect on both autism and addiction in later life.
It’s important not to leap to a conclusion without good evidence. That could divert research in unhelpful directions and hamper our ability to divine the all-important real root causes.
All we know right now is that addiction and autism are often found together, and that treatment of one can influence the treatment of the other, in manners both positive and negative.
Autism is a syndrome with a wide variety of expressions. There is no cure, but many people lead normal productive lives despite an autism diagnosis. For some people, an autism diagnosis isn’t even an inconvenience; it’s simply a different way of life.
For other people, it can be a life-long condition with profound challenges and profoundly upsetting effects. The more non-verbal a person may be, the more likely they are to experience severe disruption in their lives. The relationship between non-verbal autism and addiction is little known and poorly understood.
How people with autism can avoid the dangers of addiction
Most people with autism are diagnosed when they’re young, between ages 4 and 10. The mean age when most people start using addictive substances, including nicotine and alcohol, is between 16 and 18, although some start at age 12 or younger.
The brain is most susceptible to addiction while it develops, usually until the mid-20s. The more vulnerable a young person is, the more susceptible they will be to the use of drugs to cope with their life challenges.
Therapy is available for young adults with autism so they needn’t turn to substance abuse or can treat their existing substance use disorder. Prompt and proper treatment is the key. Specialized intervention is strongly advised.
Treatment of the addict with autism is, at this moment, still more of an art form than a science. People on the autism spectrum may have a psyche that is more complex and difficult to access than a neurotypical person.
If you are someone with autism who is also struggling with addiction or are someone who cares for such a person, great caution should be taken in choosing the right psychologist, psychiatrist, or other mental health professionals. Try to select someone with a background in autism and substance abuse since
wiley.com – Characterizing autistic traits in treatment-seeking young adults with substance use disorders
ncbi.nlm.nih.gov – Comorbid autism spectrum disorder and anxiety disorders: a brief review
samhsa.gov – Age of Substance Use Initiation among Treatment Admissions Aged 18 to 30
tandfonline.com – Introduction to the Special Issue: Examining the Relationship Between Trauma and Addiction
journals.sagepub.com. – Age at autism spectrum disorder diagnosis: A systematic review and meta-analysis from 2012 to 2019
sunshinebehavioralhealth.com – Holistic Addiction Rehab in Austin, Texas