Brief Report: Autism Spectrum Disorder and Substance Use Disorder: A Review and Case Study.

Bouck et al. (2016) wrote a short review plus one case story.

They looked at adults who have both autism and drug or alcohol problems.

The paper lists what puts these adults at risk and how treatment might need to change.

The team says standard addiction programs often fail autistic adults.

Social-communication gaps and sensory issues get in the way.

They call for plans that fit each person’s autism profile.

Ressel et al. (2020) later checked 26 studies and found drug use rates in autism range from 1 to 36 percent. Their wide range shows the 2016 paper was right to say we need clearer numbers.

Whaling et al. (2025) looked at thousands of youth and saw autistic teens actually had lower overall drug use than peers. This seems to clash with C et al.’s worry, but the 2025 study also found mental-health comorbidities and trauma push autistic youth’s risk up fast. The difference is age group and the way risk spikes when extra stressors are present.

Lo et al. (2021) reviewed behavioral addictions like gambling in autism and found shaky evidence. Together, these papers tell us to watch for both chemical and behavioral addictions, while staying alert for trauma or mental-health red flags.

You may meet autistic adults in mental-health or day programs. Add a quick substance-use question to your intake. If the client says yes, ask about sensory triggers and social skills gaps. Then team up with addiction counselors to tweak the plan: maybe shorter group sessions, written rules, or noise-reducing headphones. Small changes can keep them in treatment and out of crisis.