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A Systematic Review on the Relationship Between Autism Spectrum Disorder and Substance Use Among Adults and Adolescents
Introduction
While much of the discussion around autism focuses on social communication and sensory-processing differences, the domain of substance use remains under-explored.
The 2022 review “A Systematic Literature Review on the Relationship Between Autism Spectrum Disorder and Substance Use Among Adults and Adolescents” sought to map what is known about how autistic individuals engage with substances (including alcohol, cannabis, other drugs), and how those experiences differ from those of non-autistic peers. :contentReference[oaicite:0]0
- Why This Research Matters
- Study Overview
- Key Findings
- Implications for Practice & Policy
- The Bigger Picture
- Citation
Why This Research Matters
- Autistic individuals may face unique vulnerabilities--including social isolation, executive-function differences, emotional dysregulation, and co-occurring conditions like ADHD or anxiety.
- Historically, many substance-use studies excluded autistic people or assumed they were at lower risk of use; this review challenges that assumption.
- Understanding the intersection of autism and substance use is vital for tailored screening, prevention, and treatment practices.
Study Overview
- The review synthesised 26 studies published 2009–2019, covering adolescents and adults with autism spectrum disorder (ASD). :contentReference[oaicite:1]1
- It assessed prevalence, motives for use, risk and protective factors, and how substance-use services treat autistic people.
- While many sample sizes were small and methods heterogeneous, the authors highlighted emerging patterns and gaps.
Key Findings
🎯 1. Prevalence & Use Patterns
The review found that autistic individuals may be more vulnerable than previously assumed to substance-use problems in adulthood, though findings vary across age and methodology. :contentReference[oaicite:2]2
For adolescents, some studies showed lower overall use, but in adult clinical populations there was evidence of elevated risk.
🧠 2. Motives & Mechanisms
Autistic individuals often reported using substances for coping or regulation rather than purely recreational motives:
- To manage anxiety or sensory overload
- To self-medicate mood or executive-function challenges
- Less commonly for simply “fitting in” socially compared to non-autistic peers. :contentReference[oaicite:3]3
⚡ 3. Risk & Protective Factors
Risk factors included:
- Co-occurring ADHD, anxiety, mood disorders
- Late autism diagnosis (leading to longer unmanaged stress)
- Social isolation, adverse experiences, executive-function differences
Protective factors included: - Early autism diagnosis and supports
- Structured routines and strong social/community support
- Intellectual disability appears (surprisingly) in some contexts to reduce risk (though mechanisms unclear) :contentReference[oaicite:4]4
📉 4. Service Gaps
- Substance-use services rarely screen for autism traits or adapt interventions for autistic clients. :contentReference[oaicite:5]5
- Many autistic individuals may therefore remain under-diagnosed and undertreated with respect to substance use.
Implications for Practice & Policy
| Area | Recommendation |
|---|---|
| Screening | Incorporate autism awareness into substance-use screening; ask about executive-function, sensory matters, and social stress rather than only “peer-pressure.” |
| Prevention | Tailor outreach to autistic adolescents and adults, emphasising coping and regulation (not just abstinence). |
| Intervention | Adapt treatment settings and therapies to be autism-informed (predictable environment, concrete communication, work on regulation). |
| Research | Need for large, representative studies on substance use in autism; develop autism-tailored interventions; track lifespan trajectories. |
The Bigger Picture
This review signals that assumptions like “autistic people rarely use alcohol or drugs” may be misleading. While patterns of use differ from neurotypical populations, the risks can be just as serious, and the needs unique.
For neurodivergent communities, clinicians and policy-makers: the call is clear — design substance-use strategies with autism in mind, not as an after-thought.
Citation
Haasbroek H., & Morojele N. (2022). A Systematic Literature Review on the Relationship Between Autism Spectrum Disorder and Substance Use Among Adults and Adolescents. Review Journal of Autism and Developmental Disorders, 9(1). :contentReference[oaicite:6]6
Read full article → DOI 10.1007/s40489-021-00242-1