Standing on the corner: Where autism and addiction meet

As an autistic individual, i have faced many challenges over the years, but one of the greatest challenges i have faced was over coming addiction.

Many people view addiction as a disease, and as far as diagnostic criteria go, they’re not wrong. I however view addiction as a symptom- a symptom of an unmet support need. For me the primary unmet support need was that of my mental health, but having grown up autistic without a diagnosis, i had learnt to mask my struggles so as to fit in more effectively. When i started hearing voices i was understandably terrified, but due to the stigma surrounding mental health i believed that admitting to hearing voices would land me in an institution.

Around this time i had fallen in with a crowd of friends who like many teenagers enjoyed partying, engaging in binge drinking and drug taking as a recreational activity. I Quickly learned that drinking and taking drugs suppressed my voice hearing and the associated anxiety and paranoia. Fast forward six years and i am in the grips of addiction, my primary drugs of choices are opioids, benzodiazepines, and the increasingly infamous spice. This is where things start getting complicated.

My whole life i had been raised to understand that i was more than likely on the autism spectrum, but sadly had never been able to receive a formal diagnosis (despite repeated efforts, i was not diagnosed until age 26). This presented huge issues because i was being treated by a system that did not understand my needs fully. For two years i was misdiagnosed as having Emotionally Unstable Personality Disorder.

Perhaps more frustrating, the mental health services and substance misuse services treating me would not refer me for an autism diagnosis while i was in active addiction. I was out in the cold. Here is the key issue in this intersection between autism and addiction; autistic people are having their neurotype ignored at a time when it is vital that it be taken into account.

Substance misuse services (and mental health services in general) are not designed with autistic people in mind. Those with a diagnosis have their needs ignored, and those seeking diagnosis are asked to complete the seemingly impossible task of achieving sobriety before they can have their needs recognised.

I believe that a major contributing factor to this is the distinct lack of research conducted in the nature of co-occurring autism and substance misuse disorders. A brief search of the literature shows that very little research has been done into this overlap. It appears as if professionals do not even believe this is happening, but it is. Many autistic folk suffer at the hands of addiction, usually as a mechanism of coping with the struggles presented by their autism. Aside from suppressing my mental health issues, drugs and alcohol made it easier for me to socialise and feel like a fitted in, they also suppressed my sensory issues. Is it so surprising then that i ended up an addict?

It makes me angry that this link is so often ignored. Addiction is central to my existence just as much as being autistic. Just because i have stopped drinking and taking drugs, does not mean i am cured, it is a battle i will fight for the rest of my life, like countless other addicts. Until services reformat themselves to include autistic and other neurodivergent individuals, we will all be out in the cold, and this will not happen until the research is in place to support it.