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date: 15 July 2020

Abstract and Keywords

For many professionals, patients, and relatives of individuals with autism spectrum disorder (ASD), the co-occurrence with addiction to alcohol or drugs seems unimaginable. How could autism be hidden behind addiction and how could someone diagnosed with autism as a child become addicted in adolescence or adulthood? In this chapter, evidence is presented that this comorbidity is far more frequent in high-functioning adolescents and adults with ASD than is often appreciated. Two different perspectives are considered. First, both conditions are related to the neurotransmitter dopamine. Second, individuals with ASD may become addicted when they try and cope with their social difficulties by taking substances that help them overcome their initial shyness and social anxiety, or they do so to soothe their high levels of arousal and/or hypersensitivity to internal or external stimuli. There are established clinical guidelines for both conditions but none for managing the combination of these two disorders. Thus, the clinician, along with being acutely aware of the possible co-occurrence, should manage individual cases by tailoring an individual approach based on the evidence from both fields. This is illustrated by two clinical cases.

Keywords: autism, dopamine, addiction, behavioral addictions, drugs and alcohol

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