Autism May Increase Your Risk of Addiction

The idea that autism may increase your risk of addiction is a bit counterintuitive. Typical features of autism spectrum disorders, or ASD, are strict adherence to rules and routine, indifference to social norms, and vulnerability to overstimulation. They are also likely to need more supervision by parents and teachers. These factors would seem to make people with ASD less prone to addiction, not more. However, a large Swedish study found that autism roughly doubles your chance of addiction. There may be a number of reasons for this.

Self-medication. Like many users who become addicted, many people with ASD start using as a way to moderate their symptoms. Social interactions are particularly uncomfortable and drugs and alcohol can make them more bearable. Also, opioids and benzodiazepines can moderate the sensory overstimulation typical of ASD.

People with ASD also suffer from anxiety and depression at a higher rate than their peers. Difficulty communication, inability to adapt to new challenges, and feelings of social isolation all contribute to the elevated risk. Just as with neurotypical people, depression and anxiety can lead to drug and alcohol use as a way to cope.

Drugs are a way to fit in. Not only do drugs make social interaction less painful, but they are also an easy way to identify with a group. Improvements in ASD treatment and early interventions have increased the likelihood that someone with ASD will be mainstreamed at school. These interventions may not solve the problem of social isolation though. Drugs are often a way of establishing a social identity, and it appears to be true for ASD people as well.

Lack of support. Social isolation is one of the biggest risk factors for addiction and it’s also very likely with ASD. People with ASD often get a lot of institutional support all through school, but not once they graduate or drop out. They may struggle with finding work and making friends. The indifference to social norms that might have protected them from peer pressure in school means they may also be less concerned with the stigma of drug use as adults.

Family substance use. The Swedish study also found that the immediate family of people with ASD were more likely to have substance use issues. The authors speculated that there may be a genetic link between ASD and addiction, that substance use by parents may increase the risk of ASD, or that environmental factors lead to an increased risk of addiction. All of these are plausible. People with ASD are also more likely to suffer from OCD, which has been linked to addiction. Alcohol and drug use during pregnancy has been linked to a number of health problems in children, especially developmental disorders, which might look like ASD. And of course, for anyone, having a parent who struggles with addiction is a major risk factor.