ADHD and autistic traits were each linked to substance use in different ways
Both ADHD symptoms and autistic traits were associated with cannabis use disorders, but autistic traits showed a paradoxical pattern: less likely to drink alcohol, but more likely to develop alcohol dependence once drinking started.
Quick Facts
What This Study Found
In a study of 3,080 young adult Australian twins, researchers examined how ADHD symptoms and autistic traits independently related to substance use. Greater ADHD symptoms and higher autistic traits scores were each associated with elevated rates of regular smoking, cannabis use, and nicotine, alcohol, and cannabis use disorders, even after controlling for conduct disorder.
A paradoxical pattern emerged for autistic traits and alcohol: individuals with higher autistic traits were less likely to report drinking to intoxication (possibly due to social factors, since drinking is often a social activity), but when they did drink, they were at elevated risk for developing alcohol dependence.
The findings suggest that both ADHD and autistic traits represent independent vulnerability factors for substance use disorders, operating through different mechanisms.
Key Numbers
3,080 twins (mean age 31.9 years). Both ADHD symptoms and autistic traits independently associated with cannabis use disorders. Autistic traits associated with less alcohol use but more alcohol dependence once use began.
How They Did This
Cross-sectional analysis of interview and questionnaire data from 3,080 young adult Australian twins (mean age 31.9 years). DSM-IV substance use disorders were assessed. Logistic regression controlled for conduct disorder, sex, age, and zygosity.
Why This Research Matters
ADHD and autism spectrum traits frequently co-occur, and each independently increases substance use vulnerability. Understanding these separate pathways helps identify at-risk individuals and tailor prevention approaches.
The Bigger Picture
The finding that autistic traits create vulnerability to dependence despite lower rates of substance initiation suggests that the social protection against starting substance use does not extend to protection against addiction once use begins. This has implications for substance use screening in autism spectrum populations.
What This Study Doesn't Tell Us
Twin sample may not represent the general population. Self-report measures of autistic traits and ADHD symptoms are dimensional and not equivalent to clinical diagnoses. Cross-sectional design cannot establish causation.
Questions This Raises
- ?What mechanisms explain the vulnerability to dependence despite lower initiation rates in people with autistic traits?
- ?Would early screening and intervention for substance use in neurodivergent populations reduce disorder rates?
- ?Do ADHD and autistic traits interact synergistically to increase risk?
Trust & Context
- Key Stat:
- Both ADHD and autistic traits independently predicted substance use disorders
- Evidence Grade:
- Well-powered twin study with appropriate controls, though cross-sectional design limits causal interpretation.
- Study Age:
- Published in 2014.
- Original Title:
- ADHD symptoms, autistic traits, and substance use and misuse in adult Australian twins.
- Published In:
- Journal of studies on alcohol and drugs, 75(2), 211-21 (2014)
- Authors:
- De Alwis, Duneesha, Agrawal, Arpana(39), Reiersen, Angela M, Constantino, John N, Henders, Anjali, Martin, Nicholas G, Lynskey, Michael T
- Database ID:
- RTHC-00790
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Does ADHD increase cannabis use risk?
In this study, greater ADHD symptoms were associated with higher rates of cannabis use and cannabis use disorders, even after controlling for conduct disorder.
Are people with autistic traits at risk for substance problems?
Yes, but in a complex way. People with higher autistic traits were less likely to drink alcohol (possibly because drinking is often social) but were more likely to develop alcohol dependence once they started. They also showed elevated cannabis use disorder rates.
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Cite This Study
https://rethinkthc.com/research/RTHC-00790APA
De Alwis, Duneesha; Agrawal, Arpana; Reiersen, Angela M; Constantino, John N; Henders, Anjali; Martin, Nicholas G; Lynskey, Michael T. (2014). ADHD symptoms, autistic traits, and substance use and misuse in adult Australian twins.. Journal of studies on alcohol and drugs, 75(2), 211-21.
MLA
De Alwis, Duneesha, et al. "ADHD symptoms, autistic traits, and substance use and misuse in adult Australian twins.." Journal of studies on alcohol and drugs, 2014.
RethinkTHC
RethinkTHC Research Database. "ADHD symptoms, autistic traits, and substance use and misuse..." RTHC-00790. Retrieved from https://rethinkthc.com/research/de-2014-adhd-symptoms-autistic-traits
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.