New substance use treatment program designed for people with autism

Research suggests that people with autism spectrum disorders have an increased risk of substance use. For people with ASD and additional diagnoses, like attention deficit and hyperactivity disorder, or intellectual disabilities, the risk increases.

Despite the research, few addiction-treatment providers understand how to meet the unique needs of people with ASD, said Jessie Morriss, who manages a new substance use disorder program at Fraser, a longtime Minnesota-based provider of ASD services.

“There is a general lack of awareness and training for substance-use professionals about autism and addiction,” Morriss said. But she said that Fraser’s long focus on serving neurodiverse people means that staff at the nonprofit understand proven adaptations and approaches. 

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That understanding inspired the launch in 2024 of Fraser’s substance use disorder services, a comprehensive addiction-treatment program that serves people 12 and older who have an SUD as well as autism or other neurodevelopmental needs. 

“We built in the substance use piece to our offerings because we always knew this was part of the struggle with people we are serving,” said Aric Jensen, Fraser’s vice president for behavioral health. “We wanted to be able to serve our community in that way.” 

Recently, I spoke with Jensen and Morriss about autism, addiction and what makes Fraser’s SUD programming unique. This interview has been edited for length and clarity.  

MinnPost: There are so many addiction treatment programs in Minnesota. Why did it feel important to start this one? Were you seeing people with autism who were struggling in other types of programs? 

Jessie Morriss: All addiction treatment programs in Minnesota take people with autism. But the difficulty is that most of those programs don’t know how to apply appropriate approaches to addiction treatment for people with autism. 

In our SUD program, we base the group’s guidelines on what each client needs rather than having a standardized set of rules that group members are required to follow. Some of the traditional addiction-treatment programs have it set up where sessions are offered either in-person or virtual, but you can’t take a hybrid approach. We have it set up where clients can choose individual or virtual sessions based on their preference at that time.

We have clients who in the past may have had difficulties getting along with their peers, or interacting with others, or being in a group setting because of their autism. And we get clients who struggle with anxiety leaving the house. Being in groups can be triggering for them. We have clients who find that using public transportation isn’t comfortable. As long as they have access to the internet, they can go to our groups in the comfort of their own home. 

MP: Can you go into more detail about specific approaches for people with ASD? 

Aric Jensen: Some of the ways we support participants include preparing them for participating in the group and implementing strategies like visuals that might help them engage better in the curriculum. We are also able to take more time with folks to make sure they are getting what they need out of the groups we have. 

We serve some adults who might be under guardianship or have other barriers they might be experiencing to getting to groups on a day-to-day basis. We are able to support them in addressing those barriers to make sure they can access addiction care. We work with families or guardians in supporting clients in their goals and in getting the care they need. 

JM: Some of our clients use fidgets. If you are attending a group virtually, you are only seeing part of a person, so they would be able to use their fidgets without drawing attention to themselves. This feels important to some participants.

AJ: What it comes down to is we are serious about creating a culture that normalizes people showing up in whatever way feels comfortable for them to be able to fully participate. 

MP: You don’t require participants to be sober while taking part in your programs. Why is that? 

JM: We talk about goal setting at the beginning of our programs. For some of our clients, abstinence is the goal. They may also have other goals, like establishing boundaries and finding sober support. 

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AJ: We have a harm-reduction approach. We don’t require abstinence. We aim to meet people where they are. Their treatment goals might be abstinence and sobriety, or they might be focused on healthy and safe use if they choose to not totally abstain from substances. We’ve found this approach works well for people on the autism spectrum, and that many are actually able to reduce or stop their substance use in this manner.

MP: Why do you think a harm-reduction approach is particularly helpful for people on the autism spectrum? 

JM: There’s a lot more honesty – more of being able to focus on all the parts of a person’s life, like expanding social relationships, or boundary issues or family concerns, and not just on their substance use. 

AJ: People appreciate the fact that we’ve been able to modify the approaches based on their individual needs. They tell us our approach and programs are more beneficial for people who are neurodiverse. 

JM: I’ve been a licensed alcohol and drug counselor for 15 years. I’ve also been a licensed therapist for two years. I’m 23 years in recovery. I’ve worked in various settings, from outpatient, inpatient, to locked facilities, jails, hospitals — just about every type of setting. When you are working with people with mental health issues including autism or anxiety, it is difficult to connect with them, especially when you try to get them to comply with what feels like limiting social norms. 

Over the years, the highest rate of unsuccessful discharges I saw were with people on the autism spectrum. I’d take on people who staff deemed difficult to work with. They’d join my groups. I was able to focus on individual interventions instead of trying to fit them into a box. We don’t try to fit people into a box here.

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