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

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 pr...

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Main Authors: William Barber, Betul Aslan, Tim Meynen, John Marsden, Samuel R. Chamberlain, Vigneshwar Paleri, Julia M.A. Sinclair
Format: Article
Language:English
Published: Cambridge University Press 2025-01-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S205647242400824X/type/journal_article
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author William Barber
Betul Aslan
Tim Meynen
John Marsden
Samuel R. Chamberlain
Vigneshwar Paleri
Julia M.A. Sinclair
author_facet William Barber
Betul Aslan
Tim Meynen
John Marsden
Samuel R. Chamberlain
Vigneshwar Paleri
Julia M.A. Sinclair
author_sort William Barber
collection DOAJ
description 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.
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spelling doaj-art-2b601c3f64524148b25ca623c11fdf112025-08-20T01:49:20ZengCambridge University PressBJPsych Open2056-47242025-01-011110.1192/bjo.2024.824Alcohol use among populations with autism spectrum disorder: narrative systematic reviewWilliam Barber0https://orcid.org/0000-0002-0728-4734Betul Aslan1https://orcid.org/0000-0002-7421-5245Tim Meynen2https://orcid.org/0000-0003-0661-5391John Marsden3https://orcid.org/0000-0002-1307-2498Samuel R. Chamberlain4https://orcid.org/0000-0001-7014-8121Vigneshwar Paleri5https://orcid.org/0000-0002-2223-9210Julia M.A. Sinclair6https://orcid.org/0000-0002-1905-2025Addictions Department, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UKDepartment of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UKAddictions Department, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UKAddictions Department, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UKDepartment of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK; and Southern Health NHS Foundation Trust, Southampton, UKAddictions Department, School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UKDepartment of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, UK 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. https://www.cambridge.org/core/product/identifier/S205647242400824X/type/journal_articleAutistic spectrum disordersalcohol disorderscomorbiditymental health servicesneurodevelopmental disorders
spellingShingle William Barber
Betul Aslan
Tim Meynen
John Marsden
Samuel R. Chamberlain
Vigneshwar Paleri
Julia M.A. Sinclair
Alcohol use among populations with autism spectrum disorder: narrative systematic review
BJPsych Open
Autistic spectrum disorders
alcohol disorders
comorbidity
mental health services
neurodevelopmental disorders
title Alcohol use among populations with autism spectrum disorder: narrative systematic review
title_full Alcohol use among populations with autism spectrum disorder: narrative systematic review
title_fullStr Alcohol use among populations with autism spectrum disorder: narrative systematic review
title_full_unstemmed Alcohol use among populations with autism spectrum disorder: narrative systematic review
title_short Alcohol use among populations with autism spectrum disorder: narrative systematic review
title_sort alcohol use among populations with autism spectrum disorder narrative systematic review
topic Autistic spectrum disorders
alcohol disorders
comorbidity
mental health services
neurodevelopmental disorders
url https://www.cambridge.org/core/product/identifier/S205647242400824X/type/journal_article
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