The relationship between development on the autism spectrum and vulnerability to addiction is increasingly being analysed in greater depth. This is due, among other things, to new findings that are reflected in the latest diagnostic classifications. What do we know about this topic so far?
Table of contents:
- What is the autism spectrum?
- Changes in perceptions of the autism spectrum
- What is addiction?
- Ambiguous research findings
- Reasons for increased risk of addiction
- Treatment of addiction in people on the autism spectrum
The nature of the autism spectrum remains under scrutiny by many researchers around the world. The lack of a clear cause for its prevalence, the ever-increasing frequency of diagnosis in the population, the controversy caused by the alleged link to vaccination, and the numerous references in pop culture mean that attitudes towards autism continue to evolve. What is the autism spectrum nowadays?
What is the autism spectrum?
Autism spectrum disorder, or autism spectrum for short, is a complex neurodevelopmental variation. One approach, however, assumes that the autism spectrum is one possible variation of development within the so-called neurodiversity.
Alcohol consumption in the autism spectrum, photo by panthermedia
Key features of the autism spectrum are:
- difficulties in establishing relationships in culturally accepted ways,
- different use of verbal and non-verbal communication,
- repetitive, special interests, inappropriate to age or cultural background.
The first developmental features on the autism spectrum are already present in early childhood and remain evident well into adulthood. The prevalence of autism spectrum disorder in Europe is currently estimated at more than 6 per 1,000 births.
Changes in the perception of autism spectrum
The term 'autism spectrum' first appeared in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, which was published by the American Psychiatric Association in 2013. The severity of autistic traits is measured at three levels, depending on the level of support required.
The same is true in the eleventh edition of the International Statistical Classification of Diseases and Related Health Problems, ICD-11, which is effective worldwide from 1 January 2022. It differentiates autism spectrum disorders into as many as nine subtypes, depending on the level of intellectual development and the presence of speech. Poland is currently in the process of translating the classification into Polish and the new guidelines are expected to take effect from 2028.
Reasons for alcohol consumption by people on the autism spectrum, photo: panthermedia
What is addiction?
Changes to the ICD-11 classification have also included substance use disorders. Addiction is a disorder of control over the use of a substance, resulting from repeated use. The addicted person feels a strong need to use, even if it is harmful to their health and life. The new classification distinguishes several degrees of substance use disorders:
- risky substance use,
- harmful substance use episode,
- harmful pattern of substance use,
- substance dependence.
Experts observe a growing preoccupation with the use of psychoactive substances, including increasing per capita alcohol consumption. According to 2021 data, nearly 15 per cent of the Polish populationdrinks in a risky manner, including about 22 per cent of men and nearly 7 per cent of women.
Inconclusive research results
Could the autism spectrum be associated with an increased risk of addiction? Research conducted to date has not yet provided a clear answer.
Some of them show a reduced risk of substance dependence, while others alarm about an increased risk of falling into addiction. On the one hand, it is said that social difficulties, which are associated with fewer social gatherings where alcohol is predominantly consumed, mean a reduced risk of exposure to alcohol. Unfortunately, this does not rule out an increased tendency to abuse alcohol in the long term, due, among other things, to a tendency towards repetitive behaviour.
Autism spectrum disorder and risk of alcohol dependence, photo: panthermedia
Reasons for increased risk of addiction
There are several reasons why people on the autism spectrum may be inclined to consume various substances, particularly alcohol. The singling out of alcoholic beverages here is primarily due to:
- their availability,
- their high social tolerance,
- the strong association with social gatherings.
Not surprisingly, alcohol is cited by people on the autism spectrum as the most commonly used psychoactive substance.
One study published in December 2020 in the journal Autism Adulthood looked at the motivation to use psychoactive substances in people on the autism spectrum. The study was conducted among almost 500 adult diagnosed individuals, mainly from the UK.
Treatment options for alcoholism in people on the autism spectrum, photo by panthermedia
Its results showed that people on the autism spectrum turn to alcohol to adapt to their environment, overcome anxiety, self-medicate and even develop a career. Importantly, social reasons were more often cited by those who drank at least four drinks on one occasion. At the same time, when asked where respondents seek help for alcohol abuse, the majority indicated the Internet and self-help groups. Some 45% of the respondents did not seek anyone's help. The findings of this study were in line with research by other researchers in previous years.
Addiction treatment in people on the autism spectrum
There is no single effective therapeutic route for people on the autism spectrum. In addition to drug therapy and psychotherapy, classical detox in a hospital or rehab centre may be necessary. However, a different conclusion emerges from the research - awareness of people on the autism spectrum about the harmful effects of psychoactive substances should be raised and they should be encouraged to seek help.