Identifying the most important research, policy and practice questions for substance use, problematic alcohol use and behavioural addictions in autism (SABA-A): A priority setting partnership.
Autistic people and addiction experts have spoken: here are the ten burning questions we must answer first.
01Research in Context
What this study did
JMWaldron et al. (2023) asked 175 people around the world what questions most need answers about autism plus addiction.
The group included autistic adults, parents, doctors, and addiction workers. They voted online and in two live workshops.
After three rounds they agreed on the top ten questions: three for research, three for policy, and four for daily practice.
What they found
The final list is the first ever consensus map for autism mixed with drug, alcohol, or behavioral addictions.
Questions range from “How common is this?” to “What training do staff need?” and “Which treatments actually work?”
How this fits with other research
Cook (2002) did a similar vote two decades ago, but only for offenders with intellectual disability. The new list widens the lens to all autistic people and adds addiction for the first time.
Anonymous (2024) and Fradet et al. (2025) show most autism studies still ignore community voices. JMWaldron et al. (2023) flips that script by letting autistic adults steer the agenda.
Broadstock et al. (2007) found almost no drug trials for autistic teens and adults. The new priority list now calls for those very trials, showing the old gap is finally on the official to-do list.
Why it matters
You now have a ready-made cheat sheet when you write grants or justify new programs. Point to these ten questions and funders can see your idea is stakeholder-approved. Start by picking one question—such as “What staff training works?”—and pilot a tiny workshop. Measure staff confidence before and after. You will be doing the exact research the community asked for.
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02At a glance
03Original abstract
<h4>Background</h4>Autistic people are more likely to report problematic alcohol and other substance use when compared to the general population. Evidence suggests that up to one in three autistic adults may have an alcohol or other substance use disorder (AUD/SUD), although the evidence base for behavioural addictions is less clear. Autistic people may use substances or engage in potentially addictive behaviours as a means of coping with social anxiety, challenging life problems, or camouflaging in social contexts. Despite the prevalence and detrimental effects of AUD, SUD and behavioural addictions in community samples, literature focusing on the intersection between autism and these conditions is scarce, hindering health policy, research, and clinical practice.<h4>Methods</h4>We aimed to identify the top 10 priorities to build the evidence for research, policy, and clinical practice at this intersection. A priority-setting partnership was used to address this aim, comprising an international steering committee and stakeholders from various backgrounds, including people with declared lived experience of autism and/or addiction. First, an online survey was used to identify what people considered key questions about Substance use, alcohol use, or behavioural addictions in autistic people (SABA-A). These initial questions were reviewed and amended by stakeholders, and then classified and refined to form the final list of top priorities via an online consensus process.<h4>Outcomes</h4>The top ten priorities were identified: three research, three policy, and four practice questions. Future research suggestions are discussed.
, 2023 · doi:10.1016/j.comppsych.2023.152393