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Review
. 2025 Jan 13;11(1):e15.
doi: 10.1192/bjo.2024.824.

Alcohol use among populations with autism spectrum disorder: narrative systematic review

William Barber  1 , Betul Aslan  2 , Tim Meynen  1 , John Marsden  1 , Samuel R Chamberlain  3 , Vigneshwar Paleri  1 , Julia M A Sinclair  2
Affiliations
Review

Alcohol use among populations with autism spectrum disorder: narrative systematic review

William Barber et al. BJPsych Open. .

Abstract

Background: Alcohol use in autism spectrum disorder (ASD) is under-researched. Previous reviews have explored substance use as a whole, but this neglects individual characteristics unique to different substances. Alcohol use in non-clinical samples is associated with diverse responses. To advance practice and policy, an improved understanding of alcohol use among people with ASD is crucial to meet individual needs.

Aims: This was a narrative systematic review of the current literature on the association between alcohol use and ASD, focusing on aetiology (biological, psychological, social and environmental risk factors) and implications (consequences and protective factors) of alcohol use in autistic populations who utilise clinical services. We sought to identify priority research questions and offer policy and practice recommendations.

Method: PROSPERO Registration: CRD42023430291. The search was conducted across five databases: CINAHL, EMBASE, MEDLINE, PsychINFO and Global Health. Included studies explored alcohol use and ASD within clinical samples.

Results: A total of 22 studies was included in the final review. The pooled prevalence of alcohol use disorder in ASD was 1.6% and 16.1% in large population registers and clinical settings, respectively. Four components were identified as possible aetiological risk factors: age, co-occurring conditions, gender and genetics. We identified ten implications for co-occurring alcohol use disorder in ASD, summarised as a concept map.

Conclusion: Emerging trends in the literature suggest direction and principles for research and practice. Future studies should use a standardised methodological approach, including psychometrically validated instruments and representative samples, to inform policy and improve the experience for autistic populations with co-occurring alcohol use.

Keywords: Autistic spectrum disorders; alcohol disorders; comorbidity; mental health services; neurodevelopmental disorders.

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Conflict of interest statement

W.B. declares that this review was completed in part fulfilment of Doctorate of Clinical Psychology thesis, King's College London. S.R.C. receives a stipend from Elsevier for Associate Editor work. J.M.: in the past 3 years, J.M. declares research grants for the following clinical trials: King's College London [KCL]); Indivior (trial of extended-release pharmacotherapy for opioid use disorder; sponsor: KCL and South London & Maudsley National Health Service Trust); and Beckley PsyTech (phase 2a trial of 5-MeO-DMT for alcohol use disorder; sponsor: Beckley PsyTech). He is the senior academic advisor for the Office for Health Improvement and Disparities, English Department of Health and Social Care, and a clinical academic consultant for the US National Institute on Drug Abuse, Clinic for Clinical Trials Network. He declares honoraria and travel support from PCM Scientific, OPEN Health and Indivior to contribute to scientific and educational meetings. He holds no stocks in any company. B.A., T.M., V.P., J.M.A.S. report no declarations of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram. ADHD, attention-deficit hyperactivity disorder; ASD, autism spectrum disorder; SUD, substance-use disorder.
See this image and copyright information in PMC

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