Blog 1o - Addiction as a Form of Self-Medication: Neurodivergence and Substance Use

Sofia Bourgoignie

Sofia (she/her) is finishing her bachelor’s degree in psychology at McGill University, with a double minor in Behavioral Science and Gender, Sexuality, Feminism, and Social Justice Studies. She looks forward to applying to the University of Montreal for the psychology master’s program next year. She is passionate about the intersectionality of culture, feminism, psychology, and sexuality. What interested her in the STAR Lab was the International Sex Survey which incorporates most of her interests. Her goal is to pursue a Ph.D. in clinical psychology research intervention, focusing on issues related to trauma and sexuality intervention.

​Imagine living in a world where everything feels slightly out of sync—where sounds are excessively loud, sensations and emotions become overwhelming, or focus continually slips away despite your efforts. Many neurodivergent individuals, such as those with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), dyslexia, and other forms of neurodivergence, navigate a world not designed for their needs (Black et al., 2024). Daily life can present unique challenges, leading some to use substances like alcohol, marijuana, or other drugs to cope with societal pressures that often do not suit them; consequently, relying on substances to calm their minds or manage uncomfortable feelings becomes a coping strategy (Weir et al., 2021). While substances may provide short-term relief, they often cause long-term harm like substance use disorder (SUD). This has prompted researchers to explore the complex link between neurodiversity and substance use, especially when these behaviors are motivated by self-medication (Khantzian, 1987). This article explores neurodivergence, why self-medication develops, key risks, and the need for better support.

​Neurodivergence refers to brain differences that influence how people experience and interact with the world. As mentioned earlier, this term includes conditions like ADHD, ASD, dyslexia, and others (Black et al., 2024). Individuals with these neurodevelopmental differences face similar challenges, such as intense sensory experiences, difficulty with social cues, which can lead to anxiety, and struggles with self-regulation, focus, or organization (Weir et al., 2021). Research indicates that some neurodivergent individuals turn to substances like drugs and alcohol as a way to cope, a process known as self-medication (Weir et al., 2021). Rather than getting “high,” the goal is often to reduce anxiety, manage sensory overload, or handle social situations (Drug Foundation NZ, 2024).

​1. Why Do Neurodivergent People Use Substances?  

Managing Symptoms: Neurodivergent individuals, particularly those with ADHD and ASD, often use substances to control, intentionally or not, the undesirable symptoms of their condition. For example, using cannabis to reduce sensory overload, stimulants to focus attention, or alcohol to ease social anxiety and “fit in” better with their peers (Barber, 2025; Weir et al., 2021).
 
Masking: Some people use substances to hide or “mask” their neurodivergence, especially in social situations. This camouflaging, which is called “masking,” can lead to emotional exhaustion and worsen mental health in the long term (Weir et al., 2021).
 
Replacing or Reducing Medication: Some turn to non-prescribed substances to lessen the side effects of their prescribed medications for anxiety or depression, sometimes with mixed results (Drug Foundation NZ, 2024).

2. Patterns and Consequences of Use  

ASD and SUD Paradox: Research has found that while autistic men may use drugs less often overall, those who do are more likely to use substances specifically to self-medicate than their non-autistic peers (Weir et al., 2021). Similar rates of substance use were found in autistic women compared to non-autistic women (Barber, 2025). Although autistic individuals are less likely to engage in substance use, those who exhibit this behavior are at greater risk for developing SUD due to self-medication, co-occurring mental health issues, or lack of appropriate support (Weir et al., 2021; Barber, 2025).
 
Alcohol and Drug Use - Potential Impacts: Long-term substance use can cause many problems and worsen the very issues people try to treat. It can raise the risk of physical health problems, involvement in unsafe situations, and higher rates of suicide attempts among certain groups, especially autistic men (Barber, 2025; Drug Foundation NZ, 2024).
 
Barriers to Treatment: Stigma, high costs, and lack of specialists trained in neurodivergence remain major barriers to diagnosis and treatment (Drug Foundation NZ, 2024; Green & DeJonge, 2023). Most programs overlook neurodivergent needs, making receiving adequate help and recovery more difficult (Drug Foundation NZ, 2024).

3. The Need for Tailored Support:  

Personalized Approaches: Interventions that account for the unique neurocognitive and emotional strengths and struggles of neurodivergent people are more effective (Black et al., 2024; Drug Foundation NZ, 2024). For example, building treatment plans that include social-emotional learning, self-awareness training, or support for sensory issues can help reduce dependence on substances (Green & DeJonge, 2023).
 
Peer and Community Involvement: Incorporating lived experiences from neurodivergent individuals themselves in creating prevention and support programs adds real-world relevance and improves outcomes (Drug Foundation NZ, 2024).
 
Clinical Gaps: There is an urgent need for more clinicians trained in both addiction and neurodivergence, as current methods often fall short of addressing the core challenges that individuals with these conditions face (Green & DeJonge, 2023; Drug Foundation NZ, 2024).

​The relationship between neurodivergence and substance use is complex and influenced by biological, psychological, and social factors (Black et al., 2024). The use of substances is not a means to escape reality, but a way to cope with the daily challenges that neurodivergent brains and bodies present (Weir et al., 2021; Barber, 2025). However, the risks associated with long-term substance use remain real and harmful (Drug Foundation NZ, 2024). Understanding, compassion, and evidence-based support tailored to neurodivergent needs are vital. Therefore, a key question remains: How do we create care systems that recognize neurodiversity and offer accessible help for those who use substances to self-medicate? This conversation is just beginning, and those with lived experience must be heard.

References

Barber, W. (2025). Alcohol use among populations with autism spectrum conditions. Neuropsychiatric Care Bulletin, 21(1), 12–25. https://pmc.ncbi.nlm.nih.gov/articles/PMC11736162/1
 
Black, M. H., Lau, W. Y. P., & Rowe, T. P. (2024). Resilience in the face of neurodivergence: A scoping review of strengths-based approaches to mental health. Clinical Psychology Review, 106, Article 102209. https://www.sciencedirect.com/science/article/pii/S0272735824001089
 
Drug Foundation NZ. (2024). Neurodivergence and substance use: Evidence, insights and recommendations (Report, 1st ed., September 2024). New Zealand Drug Foundation. https://drugfoundation.org.nz/assets/PageBlocks/Downloads/Neurodivergence-and-substance-use-v2.pdf
 
Green, C., & DeJonge, B. (2023). Treating neurodivergent clients in addiction. Journal of Substance Use, 29(4), 626–632. https://doi.org/10.1080/14659891.2023.2212044
 
Khantzian, E. J. (1987). The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. The Cocaine Crisis, 65–74. https://doi.org/10.1007/978-1-4613-1837-8_7
 
Weir, E., Allison, C., Baron-Cohen, S., & Vries, A. L. C. de (2021). Understanding the substance use of autistic adolescents and adults: A mixed-methods approach. Frontiers in Psychiatry, 12, Article 665735. https://pmc.ncbi.nlm.nih.gov/articles/PMC8310943/4
​