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Initial research by Alcohol Concern, however, suggests that this assumption
doesn’t match the reality of many autistic people’s lives. Although solid evidence is
thin on the ground, a recent review by the charity of the current literature – as well
as consultations with academics and practitioners – has highlighted a number of
issues that alcohol services may need to address, as well as the need for more
thorough research into the topic.
Alcohol Concern’s investigation has revealed that although people on the autistic
spectrum do not appear, necessarily, to drink more than anyone else, that’s not the
whole story. As with many other stressful conditions, there is evidence that some
people with autism self-medicate with alcohol. There is a growing genre of ‘autism
autobiographies’ and several of these have included accounts of the use of alcohol
as a stress-management tool. Alcohol use has been found by some to be a
successful autism coping strategy in the short-term, enabling them to manage or
conceal autism-related difficulties for years – until the alcohol use starts bringing
on its own problems.
If people with autism do drink (because of their autism, or for any other reason)
there is some evidence that they are likely to have greater difficulty managing their
drinking behaviour, and be more prone towards harmful drinking and alcohol
dependence. Further problems seem to be encountered at the point at which
someone with autism is in need of support to manage their drinking.
The obvious initial obstacle is whether that person feels able to enter the
treatment system. Substance misuse treatment centres can be quite chaotic
environments, with a fairly constant flow of clients and their companions, some of
whom may be disruptive and noisy. Even if a client with autism succeeds in making
and attending an appointment, some alcohol treatment approaches – such as those
relying on analogies, abstract thinking, or a sense of social self – are likely to be
‘T
MATT’S
STORY
For many people whose
autism is undiagnosed,
alcohol can act as a
successful coping strategy
– until the alcohol
becomes a problem in
itself. Matt Tinsley
shares his story
www.drinkanddrugsnews.com
unsuitable for them. The need to be understood is often quite deep in people with
autism, and if it becomes clear early on that a practitioner does not properly
understand autism, the therapeutic relationship may stop before it starts.
Following from this initial research, Alcohol Concern is now working with the
Centre for Applied Autism Research (CAAR) at the University of Bath to explore
whether people with autism do access (or seek to access) alcohol treatment
services; what happens when they do; and how alcohol services could be made
more autism-friendly.
The ultimate aim is to work with services to make the necessary adjustments to
promote equality of access for people with autism to alcohol support w hen they
need it. Indeed, one of the most positive things that has already come out of this
project is the idea that it may be possible for services to adapt their approaches to
play to the strengths of autistic clients, i.e. to engage with them in ways that make
the most of their traits.
As part of the project, Alcohol Concern and the research team at Bath are
inviting anyone working in substance misuse services to complete a short
questionnaire. Whatever your experiences have been – even if you’re not sure
whether you’ve encountered clients with autism or how you’d recognise the
condition – they’d like to hear your views. The questionnaire shouldn’t take more
than 15 minutes to complete, and is on the Alcohol Concern website:
www.alcoholconcern.org.uk/autism
All information you provide will be anonymous, confidential and securely stored.
Contact: Andrew Misell at Alcohol Concern [email protected], and/or
Prof Marl Brosnan at the University of Bath’s Centre for Applied Autism Research
(CAAR) [email protected]
he chief aspect of my autism which
resulted in extremely heavy use of alcohol
to cope was a near constant sense of
anxiety. I also was socially awkward and
discovered alcohol turned me into a much more relaxed
person. Of course, I was unaware of my autism at the
time and it’s only in retrospect that I can understand
why it worked so well.’
Alcohol also helped Matt to function in the
workplace and develop and maintain relationships. It
meant he was less affected by sensory stressors and so
helped manage his anxiety.
‘Sensory problems which I have now such as loud
noises and certain textured clothes being very
uncomfortable were numbed to a certain extent by
drink. Being overwhelmed with information when being
given instructions was also not a problem when
drinking, as I felt able to retain the information. This
may sound like the opposite to the way alcohol would
affect NTs [neurologically typical – people not on the
autism spectrum], but I think that is the key to its
success for me, until it became life-threatening – it
made me feel and act in a much more neurotypical way.
‘Alcohol enabled me to do jobs where anxiety might
have been crippling – working in an environment with
constant contact with the public. Instead, despite being
technically drunk, I was very efficient at my jobs and
was able to cope doing such jobs for 17 years.’
However the point comes when the level of alcohol
required for functioning becomes unsustainable and
serious health issues occur. For Matt, that was severe
liver damage, collapse and certain death if he continued
to drink.
Some services have a requirement that clients be
‘dry’ before they are accepted for treatment. However
for some – possibly undiagnosed – autistic people, for
whom alcohol may be their coping strategy against
extreme anxiety, it may be the case that they cannot
access support as the removal of the alcohol may make
them incapable of leaving the house. More awareness
of the potential of autism to result in problem drinking
is needed in alcohol support services, and there also
needs to be recognition of what to look out for.
‘The signs to look for that a person with an alcohol
problem might also be autistic could be unusual eye-
contact, special interests (is there a certain level of
‘nerdiness’ in what interests the drinker, or do they have
one subject at which they are expert at?). Is their use of
language (grammar and syntax) unusual in any way,
does their conversation sound odd or pedantic? Also,
they may just present themselves, as I did, with the
conviction that they are autistic and have just
discovered why they are like they are. This should
definitely be paid attention to, and not dismissed.’
For support on all aspects of living with autism visit
www.autism.org.uk
Asperger Syndrome
and Alcohol:
Drinking to Cope?
By Matthew Tinsley and
Sarah Hendrickx,
published by Jessica
Kingsley Publishers.
May 2018 | drinkanddrugsnews | 13