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  • Antisocial Personality Disorder & Addiction | Symptoms, Risk Factors, & Dual Diagnosis Treatment

    Antisocial Personality Disorder & Addiction | Symptoms & Treatment

    Antisocial personality disorder (ASPD) is a mental condition characterized by deviant behavior and an inability to conform to social norms. Substance use disorder (addiction) is one of the most common co-occurring disorders alongside antisocial personality disorder. 

    Addiction treatment for individuals with antisocial personality disorder can pose some challenges. However, a proper diagnosis and behavioral treatment can be beneficial for both ASPD and addiction. 

    Antisocial Personality Disorder (ASPD)

    Antisocial personality disorder is recognized by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a pattern of disregard for other people and social norms. 

    People with ASPD often lack remorse for their actions, which may involve criminal or violent behavior. These behaviors usually begin in childhood and are diagnosed as conduct disorder. Conduct disorder is a high predictor for developing ASPD. 


    People with ASPD may be dishonest, violate the rights of others, and have a lack of empathy. This often leads to difficulties in relationships, at work, and with the law. 

    Although the majority of individuals diagnosed with ASPD are men, women can also be diagnosed with this personality disorder. 

    Symptoms of ASPD may include:

    • ability to be charming and likeable
    • excessive praise of others for own benefit
    • manipulate others’ emotions
    • violate laws
    • put others at risk
    • dishonest and/or violent behavior
    • lack of remorse or empathy
    • impulsivity
    • struggles with alcohol or drug abuse

    Antisocial personality is also known as sociopathy or sociopathic personality disorder. It may also be referred to as psychopathy but not all professionals agree on this comparison. 

    Substance Use Disorder (SUD)

    Although both addiction and ASPD are mental disorders, the nature of each is very different. 

    Unlike ASPD, people with substance use disorders (SUDs) often feel guilt, shame, and remorse for behaviors related to addiction. Addiction is associated with changes in brain functioning that can lead to uncontrollable drug or alcohol use. 


    Although substance use may lead to difficulties with family, work, or the law, it is not because the individual disregards socially acceptable behavior. Instead, it is due to intense cravings and physical and psychological dependence on the substance. 

    Symptoms of addiction may include:

    • cravings for the substance
    • unable to control the amount of substance taken
    • unable to stop using the substance on your own
    • high risk behaviors
    • taking increasingly higher amounts of the substance
    • withdrawing from work, family, or other relationships
    • taking drugs or alcohol to cope with mental illness 

    Although some symptoms of both mental health conditions may overlap, they are two distinguishable disorders. A dual diagnosis is when someone experiences both ASPD and a substance use disorder. 

    Risk Factors For ASPD & SUD

    Several research studies have found that having a personality disorder significantly increases the risk of also having an addiction. According to the American Psychological Association (APA), at least 80% of people diagnosed with ASPD have also had a substance use disorder. 

    In addition, genetics, environment, family history, and psychological history may also play a role in developing addiction and/or ASPD. 

    These risk factors may include:

    • child abuse or other childhood trauma
    • having an antisocial parent or alcoholic parent
    • lack of parental involvement
    • social pressures to use substances
    • using substances during adolescence
    • antisocial behavior during childhood
    • family history of drug or alcohol dependence

    Those with ASPD are more likely to start using substances at an earlier age, according to this study. Using substances early in life increases the risk of developing an addiction. 

    How Common Is Antisocial Personality Disorder & Addiction?

    Several studies have found a high percentage of people with ASPD also suffer from co-occurring substance abuse. 

    Typically, individuals with ASPD begin using substances earlier than those without the disorder. When someone develops substance abuse issues early in life, it increases the risk of progressing into a substance use disorder. 

    A study in the American Family Physician Journal of 146 adolescents in inpatient treatment reported over half the individuals had ASPD. 

    These key findings were associated with the group with antisocial behaviors: 

    • heavier and more frequent alcohol or drug use 
    • higher rates of alcohol abuse four years after treatment
    • experienced higher rates of anxiety and depression
    • increased risk of legal problems
    • experienced significantly more difficulties with relationships

    The study also found the use of substances may increase the progression of antisocial behaviors, especially in adolescents. 

    Dual Diagnosis Treatment For ASPD & SUD

    Individuals with dual diagnosis may face more challenges with recovery. ASPD is associated with dependence on multiple substances and heavier drug or alcohol use. Those with ASPD may also be less likely to seek professional help on their own. 

    Therapy & Counseling

    Although individuals with ASPD may struggle with unhealthy behaviors, cognitive behavioral therapy (CBT) and other forms of counseling can be effective. Therapy can help improve behaviors, thinking, and self-awareness. 

    Other Treatment Options

    If you suspect a loved one of exhibiting signs of ASPD or addiction, it may be time to seek treatment. Many addiction treatment centers are equipped to treat dual diagnosis individuals. 

    Dual diagnosis programs generally offer the following treatment options:

    Dual diagnosis professionals work together to provide a comprehensive treatment program that can benefit your physical, mental, and emotional health. 

    To learn more about dual diagnosis treatment, please contact Ark Behavioral Health today.

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    American Academy of Family Physician (AAFP) - Antisocial Personality and Substance Abuse
    American Psychological Association (APA) - Antisocial Personality Disorder In Patients With Substance Use Disorders
    National Library of Medicine - Antisocial Behavioral Syndromes in Cocaine and Cannabis Dependence
    National Library of Medicine: MedlinePlus - Antisocial Personality Disorder

    Medically Reviewed by
    Davis Sugar, M.D.
    on June 26, 2022
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