Addiction
Addiction is a common but treatable condition. Both autistic people and non-autistic people experience addiction, but the reasons for their addiction may be different. Addictions can be harmful to your physical and mental health. If you think you, or someone you know might have an addiction, it is important to seek help.
What is addiction?
The NHS describes addiction as 'not having control over doing, taking or using something to the point where it could be harmful to you.'
Addiction is usually associated with gambling, or substances such as drugs, alcohol and nicotine. However, you can also become addicted to other activities such as work, using the internet and gaming. It’s not known if autistic people are more likely to experience addiction than non-autistic people, as there are different kinds of addiction, and not enough research.
Having an addiction might make you more at risk of:
- physical health issues such as heart disease, stroke, liver disease/cancer
- mental health problems, for example depression and anxiety
- personal issues such as relationship breakdown, divorce, difficulties with finances, unemployment and homelessness.
How do I know if I have an addiction?
Many autistic people have particular interests or activities that they like to spend time on, but this is not considered an addiction. However, if an activity is affecting your work, finances, relationships or mood, or you are becoming dependent on the activity or substance, these could be signs of addiction.
Signs that you may have an addiction can include:
- increased risky behaviour, such as getting into debt
- regular or excessive use of alcohol or drugs
- lack of control/inability to stop the activity.
Further information on signs of addiction can be found on the NHS website.
Why might autistic people develop addictions?
People can develop an addiction if they are struggling to cope with everyday life, have a particular difficulty in their lives or have a family history/ live with others with addiction.
For autistic people there may be other reasons too. Social situations and sensory differences can make autistic people feel stressed and anxious.
Some autistic people might also use, or even become reliant on, alcohol or drugs to mask their autistic characteristics, to ‘fit in’. Frequent and prolonged use of alcohol and drugs in this way can lead autistic people to becoming addicted to these things.
Other reasons that autistic people may develop an addiction include:
- the need for routine and repetitiveness
- a lack of suitable support and services
- to help manage emotions
- a late diagnosis of autism resulting in a lack of understanding and support
- co-occurring physical and mental health conditions.
The chief aspect of [being autistic] which resulted in extremely heavy use of alcohol to cope was a near constant sense of anxiety. I also was socially awkward and discovered alcohol turned me into a much more relaxed person.
Addiction is treatable and if you feel you or someone you know might have an addiction, it is important to seek help and support.
How do I get help and support?
If you think you might have an addiction then it can be helpful to speak to someone you trust, such as a family member or friend. If you think you need more support, then speak to your GP about getting help from addiction services.
Common treatments for addiction include detox programmes, counselling and therapy. Some autistic people may find traditional therapies and treatment programmes, especially group-based ones, difficult due to the social interaction required.
The social aspect was also incredibly difficult for me. Before and after meetings involved a lot of small talk and hugging.
Autism-specific support for addiction is unfortunately not very common and most people will be referred to general addiction services. Ideally, all treatments and therapies should be delivered by someone with an understanding of autism. Most importantly, to be accessible and effective, support should be adapted to a person’s specific needs.
Visit our Seeking help with mental health page for advice on how to access help and support.
Counselling and therapy
You can go for counselling or therapy through your GP or privately. There are many types of therapy, including cognitive behavioural therapy (CBT), that can be effective for some autistic people if adapted appropriately.
Search our Autism Services Directory for details of counsellors and therapists in your area with experience of working with autistic people.
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Therapy and support should be aimed at:
- Self-control
- Motivation
- Regulation of emotions
- Time management
- Organisational skills
- Problem solving
Before the sessions:
- Provide staff with autism training, delivered by autistic people
- Get to know the individual, their strengths/challenges and co-occurring conditions
- Prepare the person – provide a photo of the therapist and room, plan the journey and consider sensory differences/accessible environment.
During the sessions:
- Use plain language, avoid idioms
- Model activities that are to be done
- Use visual/written learning, as well as vocal
- Be explicit and pace instructions – allow time for individuals to process the information
- Discuss emotions as lived experiences, not abstract labels
- Include interests and hobbies, and explain how they can be used to build resilience and motivation.
Autistic people's experience of addiction
For some autistic people, getting their autism diagnosis was key to recovery from addiction. Knowing they were autistic helped them understand some of the reasons behind their addiction, and meant they could find better ways of coping with those difficulties.
Once I had found sobriety, I had to keep it. There were two vital ingredients to maintaining my sobriety: open communication and my autism diagnosis.
Find out about autistic people's experience of addiction, treatment and recovery:
- Tinsley, M., Hendrickx, S. (2020): "Autism and alcohol" Axia Post-Diagnostic Support Group
- Gray-Hammond, D. (2021): Why did I use drugs? The feeling of being an autistic addict
- Gray-Hammond, D (2021): How can substance use services be more accessible to Autistic clients?
- Gray-Hammond, D (2021): An introduction to gaming addiction amongst Autistics
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- Autism Services Directory: for services and support
- Branches: offering support, information and social activities for autistic adults, children and their families in their local areas
- Community: our online community is a place for autistic people and their families to meet like-minded people and share their experiences
- Good practice guide: for professionals delivering talking therapies for autistic adults and children.
- Guide to asking for reasonable adjustments
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- NHS - Addiction: what is it?
- Mind - Guide to addiction and dependency support
- Action on Addiction
- Alcoholics Anonymous
- Narcotics Anonymous United Kingdom
- GamCare (for gambling addiction)
- Gamblers Anonymous
Books:
- Drinking, drug use and addiction in the autism community, Elizabeth Kunreuther and Ann Palmer
- Asperger syndrome and alcohol: drinking to cope? Matthew Tinsley and Sarah Hendrickx (2008)
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Research
Author: Coutelle et al (2021)
Title: Autism Spectrum Disorder and Video Games: Restricted Interests or Addiction?
Source: International Journal of Mental Health and Addiction , Volume OnlineFirst – Mar 8, 2021Author: Castellanos et al (2020)
Title: Substance Use in Youth With Autism Spectrum Disorder
Source: Addictive Disorders & Their Treatment , Volume 19 (2) – Jun 30, 2020Author: Hirota et al, (2021)
Title: Neurodevelopmental Traits and Longitudinal Transition Patterns in Internet Addiction: A 2-year Prospective Study
Source: Journal of Autism and Developmental Disorders , Volume 51 (4) – AprilAuthor: Helverschou et al, (2019)
Title: Treating Patients With Co-occurring Autism Spectrum Disorder and Substance Use Disorder: A Clinical Explorative Study
Source: Substance Abuse: Research and Treatment , Volume 13 – Apr 17, 2019Author: Coskun et al, (2019)
Title: Internet Use Habits, Parental Control and Psychiatric Comorbidity in Young Subjects with Asperger Syndrome
Source: Journal of Autism and Developmental Disorders , Volume 50 (1) – Sep 28, 2019Author: Ressel et al, (2020)
Title: Systematic review of risk and protective factors associated with substance use and abuse in individuals with autism spectrum disorders
Source: Autism , Volume 24 (4): 20 – May 1, 2020Author: Kawabe K. et al (2019)
Title: Internet addiction and attention-deficit / hyperactivity disorder symptoms in adolescents with autism spectrum disorder
Source: Research in Developmental Disabilities. Vol. 89, pp. 22-28Author: So R. et al. (2017)
Title: The prevalence of Internet addiction among a Japanese adolescent psychiatric clinic sample with autism spectrum disorder and/or attention-deficit hyperactivity disorder: a cross-sectional study
Source: Journal of Autism and Developmental Disorders. Vol. 47(7), pp. 2217-2224Author: So R. et al. (2019)
Title: The 2-year course of Internet addiction among a Japanese adolescent psychiatric clinic sample with autism spectrum disorder and/or attention-deficit hyperactivity disorder
Source: Journal of Autism and Developmental Disorders. Vol. 49(11), pp. 4515-4522Author: Clarke T.,et al, (2016)
Title: Substance use disorder in Asperger syndrome: An investigation into the development and maintenance of substance use disorder by individuals with a diagnosis of Asperger syndrome
Source: International Journal of DrugAuthor: Kronenberg L. M. et al. (2014)
Title: Everyday life consequences of substance use in adult patients with a substance use disorder (SUD) and co-occurring attention deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD): a patient's perspective
Source: BMC Psychiatry. Vol. 14(1), p. 264Author: Kronenberg L. M. et al. (2015)
Title: Need for care and life satisfaction in adult substance use disorder patients with and without attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD)
Source: Perspectives in Psychiatric Care. Vol. 51(1), pp. 4-15Author: Romano M. et al. (2014)
Title: The relationship between autism quotient, anxiety, and internet addiction
Source: Research in Autism Spectrum Disorders. Vol. 9(11), pp. 1521-1526Author: Van Wijngaarden-Cremers et al, (2014)
Title: Addiction and autism: a remarkable comorbidity?
Source: Journal of Alcoholism & Drug Dependence. Vol. 2(4), p. 1000170Author: Arnevik and Helverschou (2016)
Title: Autism Spectrum Disorder and Co-occurring Use Disorder: A Systematic Review
Source: Substance Abuse: Research and Treatment. Vol. 10, pp. 69–75.Author: Butwicka A. et al. (2017)
Title: Increased risk for substance use-related problems in autism spectrum disorders: a population-based cohort study
Source: Journal of Autism and Developmental Disorders. Vol. 47(1), pp. 80-89Author: Bronsan and Adams (2020)
Title: The Expectancies and Motivations for Heavy Episodic Drinking of Alcohol in Autistic Adults
Source: Autism in AdulthoodVol. 2, No. 4Original ResearchAuthor: Bowri M, Hull L, Allison C, et al. (2021)
Title: Demographic and psychological predictors of alcohol use and misuse in autistic adults
Source: Autism. 2021;25(5):1469-1480Author: Kunreuther E. (2020)
Title: Autism Spectrum Disorder and Substance Use Disorder: A Dual Diagnosis Hiding in Plain Sight
Source: Child Adolesc Psychiatr Clin N Am. 2020 Jul;29(3):467-481. Epub 2020 Apr 29. PMID: 32471596.Author: Weir E, Allison C, Baron-Cohen S. (2021)
Title: Understanding the substance use of autistic adolescents and adults: a mixed-methods approach
Source: Lancet Psychiatry. 2021 Aug;8(8):673-685. Epub 2021 Jul 1.Professional resources
Author: American Addiction Centers (2020)
Title: Drug Rehabilitation for Individuals with Autism or Asperger’s
Source: American Addiction CentersAuthor: Sparrow, M (2018)
Title: Autism and addiction: a problem with deep roots
Source: Thinking Person’s Guide to AutismAuthor: Brosnan, M. Prof (2019)
Title: Working with neurodiverse drinkers (conference presentation)
Source: Alcohol ChangeAuthor: Society for the Study of Addiction (SSA) (accessed 8 June 2021)
Title: SABAA project and the overlap between autism and addiction: Julia Sinclair talks to the SSA
Source: Society for the Study of Addiction (SSA)Author: Chamberlain, S. Prof. (2021).
Title: Behavioural addictions and autistic spectrum conditions
Source: Society for the Study of AddictionAuthor: Hendrickx, S., Tinsley, M (2016)
Title: Autism and alcohol
Source: National Autistic SocietyAuthor: Brosnan, M. Prof., Adams, S. (2019)
Title: Adapting alcohol support services for autistic people
Source: National Autistic SocietyAuthor: Brosnan, M. Prof. Alcohol Change UK (2019)
Title: Making Alcohol treatment more autism-friendly
Source: Alcohol ChangeAuthor: Szalavitz, M. (2017)
Title: The Hidden Link Between Autism and Addiction
Source: The AtlanticAuthor: Kunreuther, E., Palmer, A (2018)
Title: Substance abuse and ASD: ties, treatment and how to address the problem
Source: Milestones Autism ResourcesAuthor: National Institute for Health and Care Excellence (NICE) (2011)
Title: Alcohol-use disorders: diagnosis, assessment and management of harmful drinking (high-risk drinking) and alcohol dependence Clinical guideline [CG115]
Source: NICEAuthor: National Institute for Health and Care Excellence (NICE) (2012)
Title: Drug use disorders in adults Quality standard [QS23]
Source: NICEAuthor: National Institute for Health and Care Excellence (NICE) (2007)
Title: Drug misuse in over 16s: psychosocial interventions Clinical guideline [CG51]
Source: NICEAuthor: World Health Organisation (WHO) (2016)
Title: ICD-10-CM Section F10-F19: Mental and behavioural disorders due to psychoactive substance use
Source: ICD-11 International Classification of Diseases 11th RevisionAuthor: American Psychiatric Association (2020)
Title: What is substance abuse disorder
Source: APAAuthor: American Psychiatric Association (2018b)
Title: What is gambling disorder?
Source: APAAuthor: World Health Organisations (WHO) (2019)
Title: ICD10 version Pathological gambling F63.0
Source: ICD-10Author: WHO (2019)
Title: ICD-11 – 6C50 Gambling disorder
Source: ICD-11Author: WHO (2021)
Title: ICD-11. 6C51Gaming disorder
Source: ICD-11Author: American Psychiatric Association (2018b)
Title: Internet gaming
Source: APAAuthor: NHS (2021a)
Title: Addiction: what is it?
Source: NHS
Author: NHS (2019)
Title: Alcohol support
Source: NHSAuthor: NHS (2020)
Title: Drug addiction: getting help
Source: NHSAuthor: NHS (2021b)
Title: Help for problem gambling
Source: NHSAuthor: Internet Matters (N.D. Last accessed 22 June 2021).
Title: What is ‘gaming addiction’ and how can you prevent children from developing it?
Source: internetmatters.org
Author: National Institute for Health and Care Excellence (2021c);
Title: Autism spectrum disorder in adults: diagnosis and management
Clinical guideline [CG142]
Source: NICE
Author: National Institute for Health and Care Excellence (2021d)
Title: Autism spectrum disorder in under 19s: support and management
Clinical guideline [CG170]
Source: NICEAuthor: Kunreuther, E. (2020)
Title: Autism spectrum disorder and substance use disorder: a dual diagnosis hiding in plain sight
Source: Child and adolescent psychiatric clinics of North America. 29(3) pp.467-481Personal accounts
Author/date: Tinsley, M., Hendrickx, S. (2020)
Title: ‘Autism and alcohol’. Axia Post-diagnostic support group
Source: YouTubeAuthor: Dailor, D. (2018)
Title: My brain works differently: autism and addiction
Source: YouTubeAuthor: Gray-Hammond, D. (2021c)
Title: Why I did drugs. The feeling of being an autistic addict
Source: NeuroclasticAuthor: Gray-Hammond (2021b)
Title: How can substance use services be more accessible to Autistic clients?
Source: Emergence DivergenceAuthor: Gray-Hammond, (2021a)
Title: An introduction to gaming addiction amongst autistics
Source: Emergence DivergenceAuthor: Gray-Hammond (2020b)
Title: Limits of the traditional twelve-step program for autistic folk
Source: Emergence DivergenceAuthor: Gray-Hammond (2020a)
Title: Finding sobriety: The seemingly insurmountable challenge
Source: Emergent divergenceAuthor: Gray-Hammond (2019)
Title: Recovery services as an autistic adult
Source: Emergence DivergenceAuthor: Hokua (2019)
Title: Vlog 2: High functioning autism/Asperger syndrome and alcohol
Source: YouTubeAuthor: Tinsley, M., Hendrickx, S. (2016)
Title: Autism and alcohol
Source: National Autistic Society
Related advice and support
Last reviewed: September 2021
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