Individuals with autism spectrum disorder (ASD) have an increased risk for substance use disorder (SUD), according to a study published online Jan. 4 in JAMA Pediatrics.
Jing-Syuan Huang, M.D., from the National Defense Medical Center in Taipei, Taiwan, and colleagues examined the risk for SUD in patients with ASD and its associations with comorbidities, psychotropic agents (PAs), and mortality in a retrospective cohort study of participants from the Taiwan National Health Insurance Research Database. Overall, 6,599 individuals with ASD (mean age, 11.9 years) and 26,396 controls (mean age, 12.1 years) were enrolled.
The researchers found that compared with controls, the ASD group had significantly increased risks for SUD, alcohol use disorder (AUD), and drug use disorder (DUD), with adjusted hazard ratios of 2.33, 2.07, and 3.00, respectively, in a multivariable-adjusted analysis. In ASD subgroups with one PA and multiple PAs, the adjusted hazard ratios for SUD were 0.60 and 0.37, respectively. Comparing patients with versus without ASD with the same comorbidities, the adjusted hazard ratios for SUD were higher among patients with ASD (range, 1.17 to 2.55). For the ASD subgroup not receiving any PAs, the adjusted hazard ratio was 6.39 for SUD with comorbid tic disorder and 5.48 and 5.42, respectively, for AUD and DUD with comorbid impulse control.
“We found that patients with ASD constituted a population vulnerable to the development of SUD, particularly those who did not receive PAs and have comorbid behavioral disorders, such as impulse control disorder and tic disorder,” the authors write.