Antisocial personality disorder (ASPD), more commonly referred to as “sociopathy” in popular culture, is a mental disorder characterized by a profound lack of empathy for others, especially with regard to respecting (or not respecting) their personal rights.
According to data collected in the National Comorbidity Survey Replication (2007), ASPD was prevalent among only 1 percent of the U.S. population at the time. Unfortunately, just 46 percent of those individuals were receiving treatment for this disorder.
Considering that symptoms of ASPD often involve criminal and violent activity, spreading awareness and information about the disorder is a matter of public safety. It is also important to note that those diagnosed with ASPD have also demonstrated a high prevalence for co-occurring substance abuse.
An article published in the Graduate Journal of Counseling Psychology noted that antisocial personality disorder and borderline personality disorder are the most common personality disorders associated with substance abuse.
Furthermore, 40 to 50 percent of individuals who currently have a substance use disorder fit the profile for ASPD. Meanwhile, almost 90 percent of individuals with ASPD are also dealing with a co-occurring substance use disorder. This data suggests that it makes as much sense to discuss substance abuse as a component of ASPD as it does to consider these disorders separately.
Defining Antisocial Personality Disorder
Despite extensive research, mental health experts are still unable to determine the exact cause of antisocial personality. Typically, ASPD begins to develop in childhood. 
Children who habitually set fires or engage in animal cruelty demonstrate two common symptoms of the disorder.
Upon reaching adulthood, those suffering from ASPD will likely have developed a number of dangerous behavioral tendencies.
Major symptoms of antisocial personality disorder include:
• Extreme Lack of Empathy
• Willingness to Manipulate
• Willingness to Deceive
• Disregard for Social Norms and Laws
• Callous Attitude Toward Others
• Impulsive, Teckless Behavior
• Patterns of Risky Behaviors
Connecting Antisocial Personality Disorder and Addiction
Despite the disagreement on the causes of ASPD within the scientific community, most experts acknowledge that substance abuse and ASPD are commonly paired together in instances of dual diagnosis patients. The National Comorbidity Survey and other sets of data support this conclusion as well.
One of the reasons that it is so important to properly identify ASPD in dual diagnosis cases is because this personality disorder is prone to disrupt the recovery process. Likewise, substance abuse can further empower an individual with ASPD to engage in risky, self-destructive behaviors.
Addressing this dangerous combination of disorders requires the skill and expertise of both qualified physicians and certified therapists who have experience in treating co-occurring disorders.
Aggression and Alcoholism
One instance where research has revealed a strong connection between antisocial personality disorder and addiction is in looking at alcohol abuse.
A review of research surrounding ASPD and alcoholism published in Alcohol Research & Health identified several important conclusions about the two co-occurring disorders:
• Individuals diagnosed with ASPD generally display increased aggression.
• Individuals diagnosed with ASPD are a high risk for alcoholism.
• Individuals diagnosed with ASPD demonstrated further levels of aggression while under the influence of alcohol.
At a chemical level, the survey identified a relationship between aggression, ASPD and alcoholism revolving around the brain’s management of serotonin levels. Multiple studies have identified that the consumption of alcohol lowers the levels of serotonin, the neurotransmitter that controls mood and appetite.
Low serotonin levels are common among those who demonstrate impulsive and violent behaviors, suggesting that the ingestion of alcohol may make an individual more susceptible to the reckless behavior that characterizes ASPD.
Treating ASPD and Substance Abuse
Dual diagnosis cases are by nature extremely complex, especially when involving disruptive personality disorders like ASPD. It’s no surprise that many alcohol and drug rehab facilities are unqualified to treat an individual diagnosed with co-occurring disorders.
Only programs with sufficient experience and resources are able to provide the unique care required by an individual who is battling ASPD and substance use disorder.
At Maryland Recovery, we specialize in treating dual diagnosis clients. Our commitment to personalized recovery plans and use of holistic therapies, along with the support of our psychiatric experts, allow us to directly address the needs of patients with co-occurring disorders.
Recovery Is Possible for Those Struggling with Antisocial Personality Disorder and Addiction
Learn More About Dual Diagnosis Treatment
Reviewed by Christopher Schwartfigure MS, LGPC, CAC-AD
