Possible Autism Link in Young Adults Treated for Addiction

In late January 2022, researchers (McKowen et al.) at Massachusetts General Hospital  published findings in The American Journal on Addictions that one in five young adults being treated for alcohol or drug use may have undiagnosed traits characteristic of autism-spectrum disorder. While studies in the past have examined whether teens and young adults already diagnosed with autism spectrum disorders use substances at a higher rate than those not diagnosed, this study investigated the prevalence of previously undiagnosed autistic traits among teens and young adults with substance-use disorders.

They asked parents of youth (average age of 18.7) being treated in an outpatient substance-use disorder clinic to complete the Social Responsiveness Scale-2 (SRS-2) “which has been shown to identify the presence and severity of social impairment, and to distinguish autism from other disorders. The SRS-2 is designed to measure an individual’s social awareness, social cognition (thoughts about and interactions with other people), social communication, social motivation, and restricted interests and repetitive behaviors.”

They found that “although there were few differences between those with elevated autistic trait scores and those with lower, non-autistic scores in terms of demographic or psychiatric factors, the adolescents with higher SRS-2 scores had a nearly eightfold greater likelihood of stimulant-use disorder, and a fivefold higher risk for opioid-use disorder.”

The researchers are now developing a free clinical therapy protocol that can help clinicians better address the issues of autistic traits in patients with substance use disorders. 

This research highlights the importance of parents attending to suggestions by school personnel or others that their children have impaired social skills. It also means that clinicians who treat substance use and abuse explore social skills in detail and understand autism spectrum symptoms. Social anxiety, which may be captured by the SRS-2, is exacerbated in adolescence and may relate to substance use as a form of self-medication.