Easing social situations and promoting positive experiences may be two reasons Asperger’s and alcoholism sometimes go hand in hand.

Asperger’s syndrome was once a diagnosis given to those with mild symptoms of atypical social and communication skills but no language delay or intellect deficits. Now, it’s considered level 1 of autism spectrum disorder (ASD).

If you live with ASD, you may do things a little differently from neurotypical people. ASD is a neurodevelopmental condition, which means your brain and nervous system process information differently.

When you march to the beat of your own drum, especially in terms of social interaction and communication, it’s not always easy to engage with others. For some people living with ASD, alcohol creates a temporary buffer in social situations.

Living with ASD may both promote substance misuse and protect against it.

A 2017 Swedish population-based study of more than 100,000 people found that ASD doubled the risk for substance misuse compared to population controls.

However, the researchers noted that risk levels varied due to ASD symptom severity.

A smaller 2021 study found similar risk fluctuations within ASD. According to the data, the more severe their symptoms of autism, the less likely someone was to drink alcohol at all.

These protective features were again noted in a 2022 study on teens with autism. Teens with strong ASD traits of social disinterest, high attention to detail, and nervousness in new situations used alcohol less frequently.

Alcoholism or substance use disorder (SUD)?

Alcoholism” is an outdated term for what is now known as alcohol use disorder, a specific type of substance use disorder (SUD).

SUD occurs when you have an uncontrollable need to use a substance, despite its negative effects on your life. In its most severe form, SUD is addiction.

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Is autism and SUD common?

Although ASD may increase the risk of substance misuse, autism and substance use disorder (SUD) are still considered a rare combination.

The actual prevalence is unknown. Due to a lack of uniform research on ASD co-occurring with SUD, a 2016 systematic review found that prevalence data was inconsistent, ranging from 0.7% to 36%, depending on the specific population.

The underlying risk factors for ASD and SUD are understudied and not clearly defined in the available research.

According to research from 2017 and 2021, someone with ASD may be more likely to engage in substance use or misuse if they:

  • experience mild ASD symptoms
  • are male
  • have poor mental well-being
  • have a family member who engages in substance misuse

There are two theories about why you might drink alcohol if you live with ASD.

The main theory has to do with buffering social experiences. ASD can create challenges in interacting with others. For example, you might find it difficult to make eye contact or to follow others’ conversations.

Easing social discomfort is one reason anyone might pick up a drink.

A 2020 survey-based study found that some autistic adults engaged in heavy episodic drinking to help make verbal communication easier and to create a positive experience.

The second theory has to do with sensory numbing. It’s common for people with ASD to experience sensory overwhelm. Sounds, bright lights, textures, and smells may feel like too much all at once.

Alcohol can distort your senses because of the way it interrupts the communication between your body and your brain. This may provide temporary relief from sensory symptoms in some people.

Why ASD severity may matter

If you’re using alcohol to relieve ASD symptoms, it might sound strange that research suggests mild ASD is more closely linked with alcohol use than more severe ASD.

Experts believe this is because severe symptoms of ASD override any potential benefits gained from alcohol.

For example, in ASD level 3, which requires significant support services, you may experience a high level of social disinterest. This could mean that you’re less affected by social stress — you’re simply unaware of it and have no need to ease interactions with alcohol.

Another example would be if you experience regular high sensory discomfort. Rather than drinking to numb your senses, you may be hyperaware of the changes alcohol creates in your body, which ultimately make you more uncomfortable.

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Treating co-occurring autism and SUD presents some unique challenges.

A small 2019 clinical explorative study on this process noted that many traditional treatment options for substance misuse, such as group therapy, are not practical for autistic people who have unique communication and interaction needs.

Overall, the researchers found that cognitive behavioral therapy (CBT), when customized for a more individual and direct approach, held the most promise as a treatment option for both conditions.

CBT includes psychoeducation, relaxation strategies, and cognitive restructuring that can help you develop ways to cope and self-monitor in ASD.

Asperger’s syndrome, which is now known formally as “ASD level 1 without language or intellectual impairment,” is on the mild end of the autism spectrum. Mild ASD may be linked to an increased risk for substance use or misuse.

While there’s little research on ASD and SUD occurring together, modified CBT approaches may be the best options for dual treatment.

If you or a loved one is looking for support to quit drinking, you can find resources by visiting: