.svg){kind=icon}
.svg){kind=icon}
.svg){kind=icon}
.svg){kind=icon}
Autism and addiction
Autism and addiction are complex conditions that, when combined, present specific challenges.
Understanding these challenges can help in creating effective strategies for support and treatment.
Common addictions among autistic individuals
Substance addiction
Autistic individuals can struggle with substance addiction, involving the abuse of various commonly used substances, each carrying its own risks. Alcohol, though less frequently abused, is often used to ease social inhibitions or anxiety. Nicotine is commonly used to cope with stress, leading to widespread addiction. Marijuana is frequently used for its calming effects, while prescription opioids may be misused for pain relief or their euphoric effects. Some autistic individuals might turn to psychedelics like LSD and magic mushrooms for mind-altering experiences, though these are less common. The use of hard drugs like heroin and cocaine, while rare, poses severe risks, and amphetamines such as crystal meth, known for their stimulating effects, are highly addictive and dangerous.
Behavioural addiction
Behavioural addictions, while not involving substances, can be just as harmful. Internet addiction involves excessive online use, interfering with daily life and responsibilities. Gaming addiction can lead to excessive gaming as an escape, causing neglect in other areas of life. Gambling addiction can result in financial and personal problems due to the thrill-seeking behaviour it encourages. Shopping addiction involves compulsive buying, which can lead to financial difficulties and emotional distress.
Addiction risk factors for autistic individuals
Autistic individuals are more vulnerable to addiction than the general population, with several factors contributing to this increased risk. It's not uncommon for autistic adults to have other mental health disorders, and when paired with autism, it can lead to substance abuse behaviours as a coping mechanism. Understanding these nuances and factors is key to developing effective prevention and treatment strategies tailored to their needs.
Many autistic individuals have a strong need for routine and tend to engage in repetitive behaviours. This hyperfocus on tasks or activities, such as video games, can contribute to behavioural addictions. There is also a notable overlap between autism and Obsessive-Compulsive Disorder (OCD), where obsessive or compulsive tendencies can lead to deep attachment to specific activities, potentially leading to addiction.
Impulsivity is another factor that can increase addiction risk, especially in autistic individuals with a dual diagnosis of ADHD. Impulsive behaviours can lead to risky actions, such as experimenting with drugs or alcohol. Difficulties with impulse control can make them more susceptible to addiction after just a few uses.
Certain substances can enhance a person’s ability to focus, which can be appealing to autistic individuals who struggle in chaotic environments, like busy workplaces or noisy libraries. Drugs such as cocaine and amphetamines are often used as a coping mechanism to reduce distractions and help with focus.
Sensory overload is a common issue for autistic individuals, and substances like alcohol or certain drugs can reduce sensory overload, making the world feel less intense. This temporary relief can lead to regular use, increasing the risk of addiction.
Many autistic individuals experience social anxiety and may use drugs or alcohol to reduce social inhibitions and "mask" their symptoms. Masking involves hiding or suppressing autistic traits to fit in socially. While substances may temporarily ease feelings of social awkwardness, they also increase the risk of dependence.
Autistic individuals often face challenges that lead to negative emotions, and some may turn to drugs or alcohol to cope. Co-occurring conditions like depression and anxiety are common among autistic people and can exacerbate the desire to self-medicate, further increasing the risk of addiction.
How to recognise an addiction
Recognising addiction in autistic individuals can be tricky, especially since some signs of addiction might overlap with typical autistic traits. But there are a few key things you can look out for that might indicate a problem:
- Sudden changes in behaviour: Autistic individuals usually rely on routine and consistency, so if you notice sudden changes—like becoming more secretive, avoiding social interactions, or having erratic mood swings. They might also show increased aggression, irritability, or withdraw from activities they used to enjoy.
- Physical symptoms: Watch for any unexplained physical changes. These could include significant weight loss or gain, poor hygiene, bloodshot eyes, unusual body odours, or signs of intoxication or withdrawal. You might also notice fatigue, tremors, or unexplained injuries that could be linked to substance abuse.
- Neglect of responsibilities: If someone starts to drop the ball on daily responsibilities—like missing work, school, or appointments, or not keeping up with household tasks—it might be a sign of addiction. You might also notice a decline in their performance in areas where they used to do well, such as at work or with hobbies.
- Financial problems: Addiction often leads to money troubles. Look out for unexplained spending, frequent borrowing, selling personal items, or even stealing to support a habit. If they suddenly seem short on cash with no clear reason, it could be a cause for concern.
- Changes in social circles: A shift in who they spend time with can also be a sign. If they start hanging out with a new crowd, especially one that engages in risky behaviours, or if they pull away from family and long-term friends, this might be a warning sign.
- Preoccupation with substances or behaviours: If they become overly focused on certain substances or behaviours, talking about them a lot or planning their day around them, this could indicate an emerging addiction.
- Loss of interest in previously enjoyed activities: Autistic individuals often have specific interests or hobbies they’re passionate about. If they suddenly lose interest in these activities, it could mean that addiction is starting to take over, especially if they no longer seem to enjoy things they used to love.
- Increased risk-taking behaviour: If they start engaging in risky or dangerous behaviours that are out of character—like driving under the influence, experimenting with new substances, or engaging in unsafe practices—it could be a strong sign of addiction.
Addiction treatment for autistic people
When treating addiction in autistic individuals, it’s important to consider their unique strengths, challenges, and the level of their addiction. Their autism and any co-occurring conditions will influence the most appropriate treatment and therapy.
The first step is to see your GP and consider getting a referral to a psychologist, psychiatrist or addiction specialist who can help create an individualised therapy plan. Additionally, there are several treatment options available:
Inpatient rehab
Inpatient rehab is a residential programme where the individual stays at the facility for 30-90 days. This type of treatment provides a strict daily schedule, which can benefit autistic individuals who thrive on routine and structure. Inpatient rehab is ideal for those with severe addiction or previous rehab attempts.
Outpatient services
Outpatient rehab services offer support for drug and alcohol addiction while allowing individuals to live at home and maintain their daily routines. These programs provide a flexible way to get help without needing to stay in a facility. They usually include counselling, either one-on-one or in group sessions, and medical support such as supervised detox or medication management. Some programs focus on teaching skills to prevent relapse, ensuring long-term recovery. These services are widely available through community health centres, rehab facilities, and non-profit organisations across Australia.
Medical detox
Detoxing from substances can be dangerous, with life-threatening withdrawal symptoms possible. Medical detox provides a safer alternative, with healthcare staff monitoring vitals and providing emergency care if necessary. Medical detox can be offered in both inpatient and outpatient settings, depending on the severity of the addiction.
Therapy and counselling
Therapy is essential in both rehab programs and long-term recovery plans. Common therapies include Cognitive Behavioural Therapy (CBT), which helps reframe negative thought patterns, and family therapy, which is beneficial for both autistic teens and adults by providing a support system and educating family members about addiction and autism.
Therapy for autistic individuals should focus on building self-control, motivation, emotional regulation, time management, organisational skills, and problem-solving abilities. Therapists with experience in supporting autistic individuals are crucial, as they understand the person’s strengths, challenges, and any co-occurring conditions. It helps if the individual is well-prepared for therapy sessions; using social stories, visuals, and photos can familiarise them with therapists and new environments. Communication should be clear and simple, avoiding jargon and using real-life examples. Combining visual and written learning with verbal instructions, and allowing time for processing, are also effective strategies.
Challenges in addiction treatment
Group therapy sessions
Group therapy is a standard part of addiction treatment, but it can be overwhelming for autistic individuals, particularly those with social anxiety. They may struggle to connect with peers or understand social cues, leading to feelings of isolation.
Disruption to routine
Addiction treatment often involves establishing a new routine, which can be difficult for someone with a strict daily schedule. Autistic individuals may find this change stressful and uncomfortable.
New environment
Inpatient or residential treatment programs require individuals to live in a new environment for 30+ days, which can be particularly challenging for autistic individuals. Treatment centres may not always be autism-friendly, with stimuli like bright lights or noisy surroundings being difficult to cope with.
New people
Meeting new people, including counsellors, clinicians, and other recovering addicts, can be stressful for autistic individuals, adding an extra layer of difficulty to the treatment process.
Inconsistent accommodation
Not all treatment centres are equipped to accommodate the unique needs of autistic individuals. While some facilities are improving, there’s still progress to be made in ensuring that treatment and recovery environments are truly supportive for everyone.