The combination of antisocial personality disorder and alcoholism tends to exacerbate and strengthen symptoms of ASPD and motivates individuals to continue their engagement in risky behaviors.

Antisocial personality disorder (ASPD) and alcohol have a significant relationship. Someone with antisocial personality disorder lacks respect for structure, rules, and authority. These individuals engage in risky behaviors, lack remorse and display high levels of impulsivity. These characteristics make someone susceptible to addictive behaviors.

Addiction frequently coincides with antisocial personality disorder, with alcoholism as one of the most common. Someone with ASPD who abuses alcohol can display overly aggressive and hostile behaviors. People with antisocial personality disorder tend to have an early onset of alcohol use, develop addiction-related problems quickly and use alcohol for long periods.

Article at a Glance:

Antisocial personality disorder and alcohol abuse are commonly co-occurring and complicated to treat.

Alcohol tends to exaggerate and intensify symptoms of antisocial personality disorder like aggressiveness, impulsivity, risk-taking and lack of empathy or regard for others.

An integrated treatment model needs to be tailored to someone and focus on the personality disorder and addiction simultaneously.

It is important to keep someone engaged in treatment because setbacks and retention are often a problem in individuals with co-occurring ASPD and alcohol abuse.

Do People Drink Alcohol to Cope with Antisocial Personality Disorder?

Alcohol is often used as a coping mechanism for someone with antisocial personality disorder because they infrequently admit that they have a problem in the first place. Someone with ASPD displays an arrogant, narcissistic quality and does not consider or learn from negative consequences or occurrences. Alcohol use is more related to the impulsive and risk-taking tendencies that someone with antisocial personality disorder has. Other symptoms of ASPD include irresponsibility and a lack of regard for safety and potential outcomes.

How Does Alcoholism Affect Antisocial Personality Disorder?

Alcoholism has a negative impact on people with ASPD. The combination of antisocial personality disorder and alcoholism tends to exacerbate and strengthen symptoms of ASPD and motivates individuals to continue their engagement in risky behaviors.

People may show a higher level of impulsivity and be more willing to engage in dangerous acts. Individuals with ASPD display high levels of aggression and alcoholism increases these aggressive behaviors. Alcohol abuse can also make someone more insensitive and uncaring.

People with antisocial personality disorder are not significantly impacted by the prospect of negative consequences and alcohol use may result in them caring less about it.

Treatment for Antisocial Personality Disorder and Alcoholism

Although personality disorders are difficult to treat, treatments such as cognitive therapygroup therapy, and family counseling have shown to be effective in treating antisocial personality disorder. Antisocial personality disorder treatment becomes more complicated when addiction and ASPD are co-occurring.

Individuals with antisocial personality disorder rarely seek treatment voluntarily because they seldom accept responsibility for their actions. These individuals do not believe that they have a problem and if they do happen to seek treatment, it is often for their addiction rather than their personality disorder.

Treatment for ASPD is frequently mandated by the courts, especially for people with co-occurring conditions and other criminal offenses. Treatment retention, however, is often poor because individuals have difficulty developing and maintaining a relationship with a therapist and are more prone to setbacks. People with ASPD and alcoholism are resistant to receiving guidance from others and do not remain in treatment for a sufficient period, making treatment even more complicated.

Integrated alcohol rehab treatment that simultaneously focuses on someone’s personality disorder and alcohol addiction is imperative. Psychotherapy is the first approach of treatment and individual and group modalities are recommended. Medications can potentially help manage other psychiatric issues like anxiety or depression, that exist simultaneously. Support groups like Alcoholics Anonymous (AA) can be utilized to motivate people with ASPD to remain in treatment. AA members support and hold each other accountable to stay abstinent from alcohol, which can help a person with ASPD to move forward with their treatment.

Cognitive behavioral therapy and contingency management are two forms of treatment that have shown to be effective in people with co-occurring alcohol addiction and antisocial personality disorder. Cognitive behavior therapy seeks to raise someone’s awareness of disturbing behavior patterns to change their behaviors. Contingency management uses positive reinforcement to promote beneficial behaviors so that they occur again.

If you feel that you may be living with ASPD and alcohol alcohol abuseabuse, The Recovery Village Drug and Alcohol Rehab can help.  Mental health professionals can design an individualized treatment plan to address substance use and co-occurring disorders like ASPD. Call and speak with a representative to learn more about which treatment program could work for you.

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Medically Reviewed By – Tracy Smith, LPC, NCC, ACS
Tracy Smith is a Licensed Professional Counselor, a Nationally Certified Counselor, an Approved Clinical Supervisor, and a mental health freelance and ghostwriter. Read more
Sources “What Is a Young Antisocial Alcoholic Subtype?”  August 10, 2018.  Accessed March 9, 2019.

Buddy, T. “How Low Emotional Response Can Signal Later Alcohol Problems.” Very Well Mind, September 7, 2018.  Accessed March 9, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.