Cannabis and Hallucinogen Use Disorders Were Elevated Among Adults With Autism on Medicaid
National Medicaid data showed substance use disorder prevalence among autistic adults without intellectual disability quadrupled from 2012 to 2016, with cannabis and hallucinogen disorders particularly elevated in those aged 30-64.
Quick Facts
What This Study Found
By 2016, 7% of Medicaid beneficiaries with autism and no intellectual disability had at least one substance use disorder diagnosis, up from 1.75% in 2012 data. Adults with autism aged 30-64 were at elevated risk for cannabis and hallucinogen use disorders. Co-occurring mental health conditions (affecting 50% of autistic individuals vs 23% of non-autistic) likely compounded this risk.
Key Numbers
388,426 autistic enrollees vs 745,699 non-autistic. SUD prevalence in autism (no ID): 1.75% in 2012 to 7% in 2016 (4x increase). Ages 30-64: elevated cannabis and hallucinogen disorder risk. 50% of autistic individuals had co-occurring mental health conditions vs 23% of non-autistic.
How They Did This
Retrospective analysis of national Medicaid Claims data comparing substance use disorder prevalence among enrollees with autism (N=388,426) versus a random sample without autism (n=745,699). Examined associations by sex, age, co-occurring mental health conditions, and community-level social determinants.
Why This Research Matters
Autistic adults are an underrecognized population at risk for substance use disorders. The rapid increase in SUD prevalence and the specific elevation of cannabis disorders in this group highlights a gap in both clinical awareness and intervention development.
The Bigger Picture
As autism awareness increases and more autistic adults access healthcare, clinicians need to be alert to substance use disorder risk. The finding that half of autistic individuals have co-occurring mental health conditions suggests substance use may partly be self-medication.
What This Study Doesn't Tell Us
Medicaid claims may undercount substance use disorders. Rising prevalence could partly reflect better diagnostic coding rather than true increases. Cannot determine causation. Autistic individuals with intellectual disability were analyzed separately.
Questions This Raises
- ?Are autistic adults using cannabis to self-medicate social anxiety or sensory issues?
- ?Would autism-adapted substance use interventions be more effective?
- ?Is the increased prevalence driven by actual increases or better detection?
Trust & Context
- Key Stat:
- SUD prevalence among autistic adults (no ID) increased from 1.75% to 7% between 2012 and 2016
- Evidence Grade:
- Moderate: large national dataset with control group comparison, though limited by claims-based diagnosis and potential coding changes.
- Study Age:
- 2025 study using Medicaid data through 2016.
- Original Title:
- Comparing the prevalence of substance use disorders between persons with and without autism spectrum disorders.
- Published In:
- Autism : the international journal of research and practice, 29(7), 1674-1687 (2025)
- Authors:
- Lushin, Victor, Marcus, Steven, Tao, Sha, Engstrom, Malitta, Roux, Anne, Shea, Lindsay
- Database ID:
- RTHC-06999
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Are autistic people more likely to develop substance use problems?
This study found higher rates of substance use disorders among autistic adults, particularly cannabis and hallucinogen disorders. Co-occurring mental health conditions, which affect half of autistic individuals, appear to compound the risk.
Why are cannabis disorders elevated in autistic adults?
The study did not determine the reason, but possibilities include self-medication for social anxiety or sensory issues, greater vulnerability to dependence, or differences in how autistic people interact with substances.
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Cite This Study
https://rethinkthc.com/research/RTHC-06999APA
Lushin, Victor; Marcus, Steven; Tao, Sha; Engstrom, Malitta; Roux, Anne; Shea, Lindsay. (2025). Comparing the prevalence of substance use disorders between persons with and without autism spectrum disorders.. Autism : the international journal of research and practice, 29(7), 1674-1687. https://doi.org/10.1177/13623613251325282
MLA
Lushin, Victor, et al. "Comparing the prevalence of substance use disorders between persons with and without autism spectrum disorders.." Autism : the international journal of research and practice, 2025. https://doi.org/10.1177/13623613251325282
RethinkTHC
RethinkTHC Research Database. "Comparing the prevalence of substance use disorders between ..." RTHC-06999. Retrieved from https://rethinkthc.com/research/lushin-2025-comparing-the-prevalence-of
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.