Substance-use disorder in high-functioning autism: clinical and neurocognitive insights from two case reports

Background: Low prevalence of substance-use disorder has been reported in adults with autism. However, on a superficial level, adults with high-functioning autism (HFA) display a `normal' facade when they drink alcohol, which may explain why their alcohol dependency is not better diagnosed. Case presentation: Here, we report two cases of HFA adults who use alcohol and psychostimulants to cope with their anxiety and improve their cognitive abilities and social skills. We analyze how neurocognitive traits associated with HFA may be potential triggers for substance-use disorder. Conclusion: Better identification of autism and its cognitive impairments, which may be vulnerability traits for developing substance-use disorders, could help improve the diagnosis and treatment of substance-use disorders among this population.