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Dual Diagnosis: Substance Abuse and Autism

We live in a social world. People are always connecting on various levels at home, work, school, and other places in the community.  However, some people don’t have the social skills that make connecting easy. In fact, individuals diagnosed with autism spectrum disorder (ASD) can find it rather challenging to communicate and connect with others.

ASD is a developmental condition that affects one’s social interactions, so it makes connecting with others a bit more challenging. ASD affects both children and adults, oftentimes limiting them in the ways they interact with other people.


Researchers have studied the relationship between ASD and substance abuse.  They theorized that individuals diagnosed with some kind autism (including Asperger’s Syndrome) are more likely to abuse alcohol or drugs.  Early on, they didn’t find much correlation. But soon, more studies found links between ASD and substance use disorder (SUD).

According to the Journal of Alcoholism & Drug Dependence, one study showed that almost 7 percent of individuals in treatment for SUD had been diagnosed with ASD (as compared to 1 percent of the general population).

Researchers Elizabeth Kunreuther and Ann Palmer of the University of North Carolina have also studied the correlation between ASD and SUD. Their findings report that individuals diagnosed with autism are almost twice as likely to abuse alcohol or drugs.

They’ve written a book called Drinking, Drug Use, and Addiction in the Autism Community, which explores this relationship between autism and substance abuse further.


When one is diagnosed with ASD and SUD, it’s considered a dual diagnosis. If someone who falls within the autism spectrum has fallen prey to substance abuse, they’ll have special needs when it comes to addiction treatment. 

Locating addiction treatment facilities that cater to both diagnoses will be helpful, as other mental illnesses may need to be addressed, including anxiety and depression.

Here’s the good news: Addiction treatment facilities have started improving treatment options for individuals diagnosed with ASD. They cater to the specific needs of individuals struggling with the symptoms of autism or Asperger’s.

They aren’t necessarily trying to cure ASD. Instead, they’re trying to help patients better manage their symptoms without resorting to substance abuse.

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Oftentimes, people with ASD struggle with obsessive thoughts, which can translate  repetitive actions that evolve into various addictions. For instance, a 2013study showed that children diagnosed with ASD spent twice as much time playing video games than undiagnosed children.


For someone struggling with ASD and addiction, the treatment protocol is similar to individuals who don’t have ASD.

However, there are some differences, such as being sensitive to their need for solitude.

Therefore, individuals with ASD may not be expected to go to group therapy, as they may not be able to engage with others.

Rather, they should be allowed to engage with others as they’re comfortable with doing so.

Man with his head on a counter with pills by his hands


Cognitive behavioral therapy (CBT) has shown great results in treating those with SUD.  Essentially, CBT involves talking to a therapist about their lives and current issues. This “talk therapy” has had favorable results, even for those struggling with ASD and SUD.

Most addiction treatment centers offer CBT as part of their recovery program. It helps patients improve or manage anxiety, depression, and other negative emotions or behaviors.


Treatment centers should create specific programs that cater to individuals on the autism spectrum who are abusing substances. This tactic will involve gaining a better understanding of the disorder, as well as the particular needs of each individual.

Here are some helpful tips to implement into treatment:

  •  Complete an individual assessment of each patient, as each one will have different needs.
  •  When you have a patient with ASD, don’t rely on group performance. Encourage individual achievements.
  •  Train staff about the specific needs of patients with ASD.
  •  Provide more than one way to teach patients, such as audio and visual.
  •  Allow patients with ASD to have adequate alone time.
  •  Never force someone with ASD to participate in an activity.
  •  Consider bringing in an ASD specialist to work with these patients.


If you or a loved one has been diagnosed with Autism Spectrum Disorder and is struggling with substance abuse, it’s important to find a facility that can treat both disorders. When speaking with the intake counselor at a rehab, be sure you address your ASD diagnosis. Even if you haven’t been officially diagnosed, let them know if you suspect you have one of these disorders.

Don’t be afraid to ask the intake counselor if they have individualized treatment plans for patients with ASD. Normally, the psychiatrist or psychologist at the treatment center will be well-versed with ASD, so they’ll be able to provide individualized therapy for these patients. However, it’s best to ask before you make your final decision about treatment.


Here at Delphi Behavioral Health Group, we’re sensitive to the needs of patients on the autism spectrum. We understand their individualized needs, yet we don’t stigmatize them or allow that diagnosis to hinder them in any way. Instead, we employ specialists that can help them simultaneously manage the symptoms of ASD and substance use disorder.

Having cooccurring disorders doesn’t mean that users have to experience arrested development.  With professional treatment by compassionate practitioners, recovery is possible.


Arnevik, Espen Ajo, Lelverschou, Sissle Berge. (n.d.). National Center for Biotechnology Information. Autism Spectrum Disorder and Co-occurring Substance Use Disorder: A Systematic Review from

Medical Express. (n.d.). Autism Spectrum Disorders from

NBC News. (n.d.). Addictive Gaming And Autism from

On the Wagon. (n.d.). Autism from

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