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

William Barber; Betul Aslan; Tim Meynen; John Marsden; Samuel R. Chamberlain; Vigneshwar Paleri; Julia M.A. Sinclair

doi:10.1192/bjo.2024.824

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

William Barber, Betul Aslan, Tim Meynen, John Marsden, Samuel R. Chamberlain, Vigneshwar Paleri, Julia M.A. Sinclair^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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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.

Original language	English
Article number	e15
Journal	BJPsych Open
Volume	11
Issue number	1
Early online date	13 Jan 2025
DOIs	https://doi.org/10.1192/bjo.2024.824
Publication status	Published - Jan 2025

Keywords

alcohol disorders
Autistic spectrum disorders
comorbidity
mental health services
neurodevelopmental disorders

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Alcohol use among populations_BARBER_Publishedonline13January2025_GOLD_VoR (CC BY)Final published version, 642 KBLicence: CC BY

Cite this

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title = "Alcohol use among populations with autism spectrum disorder: narrative systematic review",

abstract = "BackgroundAlcohol 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.AimsThis 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.MethodPROSPERO 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.ResultsA 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.ConclusionEmerging 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 = "alcohol disorders, Autistic spectrum disorders, comorbidity, mental health services, neurodevelopmental disorders",

author = "William Barber and Betul Aslan and Tim Meynen and John Marsden and Chamberlain, {Samuel R.} and Vigneshwar Paleri and Sinclair, {Julia M.A.}",

note = "Publisher Copyright: Copyright {\textcopyright} The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists.",

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doi = "10.1192/bjo.2024.824",

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AU - Barber, William

AU - Aslan, Betul

AU - Meynen, Tim

AU - Marsden, John

AU - Chamberlain, Samuel R.

AU - Paleri, Vigneshwar

AU - Sinclair, Julia M.A.

PY - 2025/1

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N2 - BackgroundAlcohol 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.AimsThis 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.MethodPROSPERO 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.ResultsA 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.ConclusionEmerging 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.

AB - BackgroundAlcohol 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.AimsThis 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.MethodPROSPERO 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.ResultsA 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.ConclusionEmerging 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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DO - 10.1192/bjo.2024.824

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JO - BJPsych Open

JF - BJPsych Open

IS - 1

M1 - e15

ER -

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

Abstract

Keywords

UN SDGs

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