Distinct Drinking Patterns, Help Seeking, and Alcohol-Related Regret in ADHD, Autism, and AuDHD

Abstract ADHD is associated with higher alcohol use, while autism is linked to lower use, but little is known about patterns among individuals with both conditions (AuDHD), particularly when accounting for mental health. This study examined whether alcohol consumption, drunkenness, regret, and help-seeking differ across ADHD, autism, AuDHD, and controls, and whether regret predicts intentions to reduce drinking. Using data from the 2021 Global Drug Survey ( N = 21,246), we conducted descriptive analyses and multilevel regression models controlling for mental health and demographics. ADHD respondents had the highest AUDIT scores; autism respondents drank less overall but were more likely to fall into the possible dependence category. AuDHD respondents reported the most frequent drunkenness, highest regrets, and greatest desire to reduce drinking (42.3%). Regret strongly predicted wanting to drink less, especially for AuDHD (OR = 6.65). Findings highlight distinct risk profiles and position regret as a promising intervention target.