Autism and Substance Use Disorder: What Comes First and How Recovery Homes Can Support Both?

Understanding the Link Between Autism and Substance Use Disorder

Autism Spectrum Disorder (ASD) and Substance Use Disorder (SUD) are both complex and often misunderstood. When they occur together, the journey to recovery becomes even more challenging and critical to get right.

While earlier studies suggested low rates of substance use among autistic individuals, recent research published in The Lancet Psychiatry reveals that autistic adults without intellectual disabilities are significantly more likely to develop substance use, disorders often using drugs or alcohol to cope with sensory overload, anxiety, or social isolation.

So which comes first, autism or addiction? The better question is: how do we treat both effectively, together?

Autism infinity ribbon and purple recovery ribbon

What Comes First: Autism or Addiction?

Autism is a neurodevelopmental condition present from birth, even if not diagnosed until later in life. Substance Use Disorder is a chronic, relapsing disease of the brain,not a moral failing or a matter of willpower. However, specific life experiences and conditions can increase the risk of developing it.

For many autistic individuals, the daily effort to navigate a world not designed for their needs can lead to chronic stress, anxiety, trauma, or isolation.

These factors don't cause addiction, but they can increase the likelihood of developing SUD in those who are already biologically vulnerable.

In some cases, autistic individuals may begin using substances as a way to self-regulate or cope, particularly when other supports are unavailable, or they've spent years masking their differences.

Conversely, chronic substance use can amplify traits like emotional dysregulation or sensory issues, which may delay or obscure an autism diagnosis.

That's why recovery support must be integrated, compassionate, and informed by both diagnoses.

The Role of Recovery Homes in Dual Diagnosis Care

For individuals living with both autism and substance use disorder, the transition from treatment to long-term recovery must be customized. Recovery homes can play a critical role when adapting to neurodiverse needs. Here's how:

1. Predictability and Structure

A consistent daily schedule helps reduce anxiety for autistic individuals and provides stability in early recovery.

2. Sensory-Friendly Spaces

Homes must account for overstimulation: quiet rooms, flexible participation in group activities, and sensitivity to noise and lighting matter.

3. Neurodiversity & Informed Staff

Recovery staff should understand how autism may present in adults and be trained to avoid misinterpreting behavior through a neurotypical lens.

4. Flexible Coaching and Support

One-on-one coaching, alternative therapies, visual tools, and executive functioning support can make recovery more accessible and sustainable.

5. Integrated Mental Health Care

Partnering with mental health professionals trained in autism and addiction ensures residents receive complete, individualized care.

Next Recovery's Experience with Dual Diagnosis

At Next Recovery, we work with many residents navigating dual diagnoses, including autism, ADHD, PTSD, depression, anxiety, and substance use disorder.

We understand that recovery is not one-size-fits-all—especially for neurodivergent individuals.

Our coaches and staff are trained to recognize when traditional models aren't working and adapt accordingly.

Whether that means modifying communication styles, allowing extra processing time, or building a personalized support system, we meet each resident where they are, neurologically and emotionally.

We've seen firsthand that when autistic residents receive the right kind of structure and support, they often thrive in recovery. But it takes a flexible, trauma-informed, and neurodivergent-affirming environment to get there.

"Some of the most committed residents I've ever worked with are those on the spectrum," says Clint Britton, founder of Next Recovery, a FARR-certified recovery residence in Florida.

"They've fought hard just to exist in a world that often misunderstands them—so by the time they reach us, they're ready to rebuild. But traditional recovery programs weren't designed for neurodiverse minds. That's why we've adapted our structure to meet their needs, not vice versa."

Building Recovery That Lasts

We believe that everyone deserves a chance to recover fully, not just from substance use but from a life of masking, misdiagnosis, or being misunderstood. That's why at Next Recovery, we don't separate diagnoses—we integrate care.

Because real recovery starts when people feel seen, supported, and safe to be themselves.

To learn more contact Next Recovery or call 352-363-9709.

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Stats and Lesser Known Insights

• A 2023 study in The Lancet Psychiatry found that autistic adults without intellectual disabilities are nearly twice as likely to develop substance use disorder compared to non-autistic peers.

• Drexel University research shows that about 20% of autistic adults report co-occurring substance use challenges.

• Masking: suppressing autistic traits to fit in socially is associated with emotional exhaustion and increased risk of substance use.

• Autistic individuals are also more likely to experience late diagnoses, trauma, bullying, and unemployment, all key risk factors for developing SUD.

• Traditional 12-step recovery models often rely on verbal processing and social comfort, which may not work for neurodivergent individuals, contributing to higher dropout or relapse rates unless modifications are made.