Can Autism in Adults Be Masked by Substance Misuse?

PostedNovember 6, 2025

UpdatedNovember 6, 2025

ByMy Patient Advice

Author: Beatrice Holloway, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Yes, substance misuse and autism are often intertwined, with substance use sometimes acting as a coping mechanism that masks the underlying traits of autism in adults. Many individuals with undiagnosed autism may turn to substances to self-medicate, trying to alleviate the sensory sensitivities, social difficulties, or emotional regulation challenges they experience. This behavioural masking can prevent the true nature of their condition from being recognised, delaying an accurate diagnosis.

Substance misuse often becomes a temporary escape from the overwhelming feelings that come with autism. While it may offer short-term relief from anxiety or frustration, it does not address the core issues associated with autism. Consequently, the symptoms of autism can remain hidden behind substance use. Without the correct diagnosis and support, individuals may struggle with both their substance use and the unaddressed challenges of autism.

Common Symptoms of Autism Masked by Substance Misuse

The common symptoms of autism masked by substance misuse are as follows:

Social Withdrawal:

Adults with autism may have difficulty navigating social situations, which can lead to isolation. Substance misuse can exacerbate this withdrawal, creating a false sense of comfort. Support through CBT can help manage social anxiety and improve social engagement.

Emotional Dysregulation:

Both autism and substance misuse can lead to emotional instability. Substance use might provide temporary relief, but it doesn’t address the underlying emotional challenges of autism. Emotional regulation strategies can help manage these difficulties more effectively.

Sensitivity to Change:

Autism often leads to stress around changes in routine or environment. Substances can act as numbing the discomfort but not providing lasting solutions. Therapy focused on building flexibility can improve adaptability to change.

For personalised support, visit providers like Autism Detect for personal consultations tailored to your needs.

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to late diagnosis in adults.

Beatrice Holloway, MSc

Author

Beatrice Holloway is a clinical psychologist with a Master’s in Clinical Psychology and a BS in Applied Psychology. She specialises in CBT, psychological testing, and applied behaviour therapy, working with children with autism spectrum disorder (ASD), developmental delays, and learning disabilities, as well as adults with bipolar disorder, schizophrenia, anxiety, OCD, and substance use disorders. Holloway creates personalised treatment plans to support emotional regulation, social skills, and academic progress in children, and delivers evidence-based therapy to improve mental health and well-being across all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.