When Substance Use Services Fail Autistic People

Exploring The Experiences Of Autistic Adults In Substance Use Treatment

Our recent study in Autism in Adulthood as part of our work at ASUN (Munday et al, 2025) has once again highlighted something many of us have known through lived experience: the systems that claim to support Autistic people often do the exact opposite.

We found that most participants reported serious mental health issues alongside substance use. 87% experienced anxiety, 75% had depression, and many were also ADHDers. Chronic pain was another common reality. For many, substances were not about recklessness or traditional ideas of addiction, but strategies for survival:

• Coping with anxiety, depression, or sensory overwhelm

• Focusing and boosting energy in a world not designed for monotropic minds

• Building confidence in social situations where neuronormativity dominates

It seems clear to me that what we often frame as addiction is instead a desperate attempt to fulfill unmet needs and survive in a deeply hostile world.

The most common substances were alcohol, cannabis, and stimulants.