Antisocial Personality Disorder and Substance Abuse

Substance abuse is common among individuals suffering from antisocial personality disorder (ASPD). This disorder typically comes with poor impulse control, leading them to engage in riskier behaviors than those without ASPD.

Substance abuse is common among individuals suffering from antisocial personality disorder (ASPD). This disorder typically comes with poor impulse control, leading them to engage in riskier behaviors than those without ASPD. These behaviors include sharing needles with others resulting in HIV or hepatitis. Struggling individuals do not believe that the rules apply to them and have no concern of the harm that could be brought to their bodies. An ASPD patient’s complete denial of their addiction or problems increases the intensity and length of substance abuse. The negative toll addictive substances take on one’s health increases over time, with higher rates of use placing people at a higher risk for permanent brain damage and chronic health problems.

Drug Abuse as a Hindrance to Antisocial Personality Disorder Treatment

Drug use can increase symptoms of antisocial personality disorder, creating a limitation to positive treatment outcomes when only focusing on the personality disorder. The existence of both substances abuse and ASPD would require dual diagnosis treatment, meaning both disorders are central to the treatment of the individual.

If ASPD symptoms are decreased during therapy or medications treatments, there is a greater risk for these symptoms to reappear if the individual is abusing drugs. The drug use will ignite those symptoms of aggression, lack of impulse and belligerence hindering any chance of treatment unless the drug use is treated as well.

Effects of Substance Abuse on Antisocial Personality Disorder Symptoms               

For people struggling with substance abuse who also have antisocial personality disorder, it can be a monumental struggle to get through an entire drug or alcohol treatment with no management of the personality disorder. The National Institute of Drug Abuse’s research proves long-term addiction or drug abuse can have widespread negative impacts on mental function, psychological well-being and physical health. Substance abuse can exaggerate the antisocial personality disorder symptoms and increase the negative effects of the substances over time.

Statistics on Antisocial Personality Disorder and Drug Abuse               

The National Institute for Drug Abuse estimates that between 40 percent and 55 percent of patients who enter treatment for addiction or substance abuse have antisocial personality disorder. Another study suggested that as much as 90 percent of individuals with antisocial personality disorder have a co-occurring substance use disorder.

Antisocial Personality Disorder and Alcohol        

Alcohol abuse is one of the most frequent forms of addiction found in individuals with antisocial personality disorder. Alcohol use in an individual with antisocial personality disorder causes them to become more aggressive and exhibit violent behavior.

The severity of symptoms from alcohol abuse continues to increase over time among individuals with antisocial personality disorder. The combination of alcohol and ASPD is associated with:

• More severe disorders.
• Higher likelihood of negative long-term drinking.
• Decreased efficacy of treatment.
• Higher rate of criminal activity.
• High levels of thrill-seeking behavior and impulsivity.

Antisocial Personality Disorder and Marijuana

Individuals with antisocial personality disorders exhibit more continued use of marijuana, despite clinically significant distress or impairment than those without the disorder. Age of initial marijuana use is typically much earlier in people with antisocial personality disorders. Even without the presence of addiction, symptoms associated with marijuana dependence increase over time in those with personality disorders. They have difficulty controlling their usage.

Antisocial Personality Disorder and Stimulants   

The use of stimulants may intensify already-present impulse behavior, aggression and other mood disturbance seen in patients with antisocial personality disorder. The use of cocaine and ecstasy are prevalent among the ASPD population. Research conducted by the Drug and Alcohol Dependence found that people with antisocial personality disorder who abuse stimulants are more likely to drop out of treatment and engage in more risk-taking behavior than those using other substances or not using at all.

The most used stimulates of individuals with antisocial personality disorder include:

• Benzedrine and other ADHD treating medications.
• Methamphetamines
• Cocaine
• MDMA
• Energy Drinks or over the counter energy tablets
• Nicotine

Drug Abuse as a Cause of Antisocial Personality Disorder

Because antisocial personality disorder is associated with an earlier age of onset for drug and alcohol use, it is uncertain if the addictive behavior comes before or after the disorder exists. The early usage of alcohol and drugs that is common among ASPD patients could affect the brain chemistry to the young individual, which produces the disorder. Whether or not drug abuse is a cause, it does greatly elevate the negative symptoms and make treatments more challenging.

Treatments for Antisocial Personality Disorder with Co-Occurring Substance Use Disorders          

Individuals who have a co-occurring condition of ASPD and substance abuse have a difficult time being treated and coming into recovery. In order to treat a co-occurring condition, both disorders must be the center focus. When one of the conditions goes untreated, the treated condition often resurfaces over and over until both disorders are managed. Individuals who have antisocial personality disorder are high risk for a co-existing substance abuse disorder.

These individuals should look for certain qualities in a dual-diagnosis rehab that will treat both antisocial personality disorder and substance addiction together. The best inpatient dual diagnosis facilities will provide services such as:

• Intake evaluation
• Detox
• Medical maintenance
• Therapy
• Group counseling
• 12 step programs
• Holistic wellness programs

The patient is evaluated for any undiagnosed mental health conditions, and the severity of disorders will be addressed. Inpatient care will provide around-the-clock care while detoxing from alcohol or drugs. Though not typical for someone in this situation, it is possible that the patient will be prescribed medication to treat anxiety or depression or severe aggression. These medications are beneficial to antisocial personality disorder symptoms, though because they are being treated for substance abuse, this may not be offered for each case.

Therapists who are experienced in treating antisocial personality disorder will work patiently with the individual on aggressive and controlling behaviors. Group counseling can be effective for learning pro-social skills and sharing experiences with others.

Even though individuals with ASPD often face exclusion from treatment facilities due to their violent or manipulative behaviors, treatment is possible. The Recovery Village is one facility that can help with symptoms of antisocial personality disorder when it’s a co-occurring disorder along with addiction. People who struggle with antisocial personality symptoms can receive help from one of the facilities located in each region of the country. If you or a loved one suffers from antisocial personality disorder and an addiction to drugs or alcohol, call The Recovery Village to speak with a representative.

Editor – Devin Golden

Devin Golden has worked for various print and digital news organizations. Devin's family has been affected by addiction and mental health disorders, which is a large part of why he wants to help others who have either directly or indirectly been affected by these diseases. Read more

Medically Reviewed By – Krisi Herron, LCDC

Krisi Herron is an Adjunct Psychology Professor, a Licensed Chemical Dependency Counselor and a freelance writer who contributes to several mental health blogs. Read more