ORN Clinical Roundtable: Substance Use Disorder in Neurodivergent Teens-Slides

Slides

Pdf Summary

The presentation explains how neurodevelopment and life experiences shape substance use disorder (SUD) risk in adolescents, with a focus on ADHD and autism spectrum disorder (ASD). During adolescence, reward-seeking is heightened while cognitive control is still developing. Repeated substance use can alter reward processing, especially when young people have limited access to supportive, rewarding experiences.<br /><br />ADHD-related dopamine and norepinephrine differences, executive-function difficulties, and challenges accessing natural rewards are associated with earlier substance use, faster progression to severe SUD, and greater risks of opioid, stimulant, and polysubstance disorders. People with ADHD may also be more likely to disengage from treatment or return to use when care is not adapted to their needs.<br /><br />For autistic people, social-communication differences, concrete thinking, sensory overload, and co-occurring conditions can increase vulnerability. Substance use may be used to manage social or emotional strain or to fit in, while risks can include exploitation, overdose, hospitalization, and difficulty accessing care. Standard group-based or introspection-focused treatments may not be a good fit.<br /><br />The case of a young adult with ADHD and ASD illustrates how substance use that began as a way to socialize escalated alongside academic and executive-function challenges, ultimately contributing to serious mental-health symptoms. The presentation emphasizes early identification, acceptance, and tailored support. Suggested adaptations include concrete skills training and modified one-to-one CBT for autistic teens, and executive-function support or cognitive remediation for people with ADHD.<br /><br />The Opioid Response Network (ORN), funded by SAMHSA, offers local education and technical assistance to support evidence-based prevention, treatment, and recovery for opioid and stimulant use disorders. It encourages building on existing community efforts and addressing local needs.

Keywords

adolescence

substance use disorder

ADHD

autism spectrum disorder

reward processing

executive function

opioid use disorder

stimulant use disorder

tailored treatment

Opioid Response Network