Why We Need More Research on How Substance Abuse Impacts the Autistic Community

I will always remember the first few times I tried an alcoholic beverage. I was around the age of eighteen, and at first found the feeling very uncomfortable. Even a slight buzz—just a partial alcoholic beverage—changes my perception and how I experience my senses. But what I found at first to be really disconcerting (like the fact that I generally say whatever is on my mind when I’ve had a drink, which is an autistic feature that I learned to “turn off” a long time ago to adapt to social settings) started to feel freeing.

A new study in Sweden suggests that autistic people are more than twice as likely to become addicted to substances like drugs and alcohol than our peers are. (The study makes this distinction for autistic people with “average or above average IQs,” but I don’t personally find IQ or functioning labels useful when discussing autistic communities.) The risk is even higher for people who also have ADHD, like I do. This is the first study of its kind, and autistic people were previously pretty much ignored in research about substance abuse.

“I began smoking and drinking alcohol when I was in my early teens,” says Laura James, an autistic author and journalist from Norfolk, England. “Although my autism wasn’t diagnosed until relatively recently, at the time, I remember noticing that both made me feel less stressed and socially awkward. Post-diagnosis it became immediately apparent I had been self-medicating.”

While I don’t identify as an alcoholic, I have absolutely used alcohol to cope with some of my autistic features.

Drinking does amplify some of my features; I have even more trouble with face blindness, proprioception, directions, and stopping or starting tasks. But it also eases most problems with sensory awareness: Loud noises, bright lights, and uncomfortable surfaces all bother me significantly less when I’m under the influence. I almost always have a drink or two when I’m going out to a bar, because all the things I dislike about bars—how hard it is to talk and hear, the sticky floor from spilled booze, people bumping into me—fades away if I have a drink or two.

Emm, a software engineer, painter, and writer from the New York City area, also finds that substance use can ease social difficulties that are common for autistic folks. They say, “Using substances, specifically marijuana, provided me with the illusion that I ‘fit in’ with social situations. All of my friends smoked marijuana, and when we smoked to together, it seemed to bring us to the same level.”

I don’t have as many challenges with social situations as some of my autistic peers. Despite being face blind, I’m really adept with body language, tone of voice, and facial expressions, so I can tell when someone isn’t into a long conversation about my special interests or when they’re just dying to tell me about their day. But still, like most autistic people, I feel socially different; I hate small talk and tend to be emotionally vulnerable sooner than people expect.

Alcohol helps those differences fade. It’s much easier to excuse the things that usually make me noticeable in a group of neurotypical people, like my tendency to enjoy controversial discussions or how excited I can get about something small, when it can be passed off as “Alaina’s tipsy.” When I don’t know where I’m going or I fall on my face just walking to the bathroom, we can all laugh about it, because suddenly I’m not the only person with a balance deficit.

Alcohol and drugs may seem like a quick fix to self-medicate, but problems with addiction and substance abuse are serious problems that can be difficult to treat. Addiction runs in my family, so I’m always careful about how and when I use alcohol. I don’t want it to become a coping mechanism for sensory overload or autistic burnout.

It’s clear that we not only need more research about how substance abuse affects autistic people, but also treatment specifically designed for our community. Our treatment needs to be focused on our needs, not on forcing us to present as neurotypical and non-autistic, and should be adaptive to individual differences.

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Alaina Leary is the communications manager of We Need Diverse Books. Her work has been published in New York Times, Washington Post, Cosmopolitan, Teen Vogue, Refinery29, The Oprah Magazine, Healthline, and more. She lives with her wife and two cats in Boston. You can find her on Twitter and Instagram @alainaskeys.