About one third
of all people living with a mental disorder are also coping with some form of substance abuse. This seems to be largely because of a comorbidity effect, where each condition plays a role in fueling the other. As discussed in this guide, there is evidence that this is true for those struggling with addiction issues who fall somewhere on the autism spectrum.

This guide is designed to support those facing the dual diagnosis of autism spectrum disorder (ASD) and some form of addiction. It will help you understand the ways they affect one another as well as options for treatment. Always consult your doctor before committing to a recovery regimen; it’s important for you to work together to figure out the best treatment so you can forge the path to a healthier life.

The Role of Comorbidity in Addiction

Until recently, it was thought that those falling on the autism spectrum were actually at a lower risk for addiction. Because one of the defining characteristics of autism is social withdrawal, drinking with peers tends to be an unlikely occurrence. A recent study, however, had an interesting find: although those with autism were no more likely to drink or use marijuana, they were more likely to become addicted or abuse the substances if they did use them.

So then what causes some on the autism spectrum to begin using a substance? It seems to be that individuals with ASD who long for social contact but are shy or socially awkward may use substances to facilitate smoother social encounters. Another possibility is that substances can simply be a way to cope with the tension or anxiety of required social engagements (interactions in the workplace and family gatherings, for example). A common characteristic of ASD is repetitive action so those who do choose to use substances tend to repeat the behavior, putting them at an increased risk for dependence.

Many addicts face similar difficulties interacting with others in a social setting. Like those with ASD, this is sometimes what leads to a substance problem in the first place. The behavior may be repeated initially due to enduring social anxieties, personal problems, or even peer pressure, and develop into a physical dependency over time.

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One of the most important commonalities between addicts and those on the autism spectrum is a tendency toward preoccupations. People with ASD help regulate anxieties and hypersensitivities by finding preoccupations and sticking to them; in other words, finding a single action to focus on at length or repeatedly can create a valuable sense of stability and consistency that can be difficult to find in daily life. Similarly, addicts develop a preoccupation with the substance they abuse. This can even be viewed as a common evolutionary development, whereas both addiction and ASD symptoms are interpreted as coping strategies (or sources of comfort) in a world of uncertainty. Together, the two can fuel each other: social relation problems may lead to repeated drug use, and sometimes to addiction; in turn, addiction reinforces the repetitive nature of ASD. This is often referred to as comorbidity.

And the comorbidity effect doesn’t stop with the onset or continuation of addiction; recovery can often be more difficult, as well. Those on the autism spectrum tend to have a more detailed perception and compulsive habits, so seemingly small details can trigger a relapse. For example, a recovering heroin addict with ASD may become consumed with thoughts of using after seeing an object associated with the drug (such as a syringe at the doctor’s office or aluminum foil in the kitchen). Though the sight may trigger a visceral response in most heroin addicts, those with ASD may have an especially difficult time shifting thoughts away from the idea of using due to the cognitive effects of their disorder.

Treatment Options

The most effective form of treatment for a dual diagnosis of a drug addiction and ASD is integrated intervention: your regimen should simultaneously address your autism symptoms as well as your substance abuse, including the effects each has on the other. The first step after recognizing that you have a problem is withdrawing from the substance, which may be one of the most challenging parts of the recovery process and usually calls for constant monitoring by nurses, doctors, and recovery specialists. Depending on your individual needs, your physician may opt to wean you off the drug by administering tapering amounts or giving you its medical alternative. This can help lessen withdrawal symptoms and make the transition easier for both body and mind, but only a doctor will be able to decide if it’s the best route for you.

For the detoxification process, it’s usually best to go through inpatient care rather than outpatient. This allows for a much-needed level of consistency, removing you from exposure to people, places, and objects associated with using. It also gives you constant access to medical professionals to help you overcome withdrawal symptoms and keep you on track for recovery. Most treatment regimens will also offer therapy not only to help you adjust and work through your cravings, but to help identify contributing factors to your addiction.

When your body has started to physically recover from the withdrawal your doctor will help you start to address the psychological causes of your substance abuse, which are likely tied to your ASD. While much of your work will likely be one-on-one, it may also call for group work. Group therapy can be beneficial for many reasons: it allows a valuable outside perspective to dissect your issues, an outlet to vent frustrations about both your addiction and your ASD with people who truly understand what you’re going through, a place to form friendships and receive peer encouragement, and first-hand insight on coping methods, community resources, and other tips on what can make your process a little easier. Though the help of a professional is certainly vital to your recovery, dealing with either condition — let alone a dual diagnosis — can be isolating, so it’s important to feel that you have peers you can turn to throughout your journey.

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Your individual, one-on-one therapy will likely begin with your therapist talking to you about the specifics of your situation. It’s important for you to have a comprehensive understanding of your particular form of ASD. Further, you should also know how the substance you use affects the human body and mind, people with ASD in general, and the ways it affects you specifically. It’s possible that the struggles you face daily that you assume are associated solely with your ASD are amplified by your drug abuse; knowing what those things are will not only give you a better understanding of yourself, it could even be motivation to keep you clean.

A common method for dual diagnosis treatment is cognitive behavioral therapy (CBT). Focused mostly on talk therapy, it’s a way to help you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond in a more effective way. An important part of CBT for addiction recovery is learning how to accept messages from your mind without placing judgment upon them. For example if you’ve realized that social anxiety is a major factor in your addiction, your therapist might have you consider your mental approach to a party or social gathering. Does your mind immediately jump to the assumption that you’ll say the wrong thing and be rejected? Thoughts like this can contribute greatly to drug abuse, so your therapist can help you find ways to combat those thoughts and re-train your brain to focus on more positive thinking. The goal isn’t to change who you are, but to help you accept and love yourself for who you are, ASD and all, and live comfortably in your own skin. Once you can do this, you won’t have to lean on drugs or alcohol for comfort.

Don’t forget to reach out to friends and family for support throughout your recovery process. Though your brain may be telling you that they won’t understand, don’t let those negative ideas win. Your loved ones want you to live a safe, healthy, happy life and will likely do whatever they can to help. Even if they don’t completely understand what you’re going through, they can act as a shoulder to lean on and unconditional support. It’s important that your mind is focused on battling your addiction instead of hiding it, especially if that means keeping it from those who love you most. Having your loved ones behind you will not only be a source of comfort, it can be an excellent way to keep you motivated and on the right path forward.

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Overcoming addiction while coping with autism spectrum disorder may seem like an uphill fight. But with the right mindset, treatment plan, and support, recovery isn’t out of your reach. Your struggle may be a particularly tough one, but when you triumph over it and learn to love and accept yourself for the resilient fighter you are, you’ll come out stronger and happier than ever before.