Treatment for Antisocial Personality Disorder and Addiction

Individuals with antisocial personality disorder (ASPD) have no respect for other people’s feelings. They are manipulative and have no guilt for the way they treat people. The treatment for antisocial personality disorder can be challenging but rewarding.

What is Antisocial Personality Disorder?

People with ASPD are sometimes called sociopaths. ASPD causes patterns of manipulation, lying, and the invasion of people’s rights. Those with ASPD are not sorry for their actions. This behavior causes problems at work and in relationships.

People with ASPD are funny, entertaining, and charismatic. But this is part of the manipulation. Every action is methodically planned and is for their benefit. ASPD takes over their character and pushes people away.

It is assumed that ASPD is a mixture of two mental health conditions. A psychopath is a person whose hurtful actions are planned and manipulative. They feel no emotion or empathy for others. Sociopaths form attachments but have no respect for personal rights. They are easily upset and unpredictable.

Symptoms of ASPD

While lying and manipulation are the main traits of ASPD, a person can be charming. They may be unstable, violent, and impulsive without any guilt. Other signs and symptoms of ASPD include the following.

  • Disregard for what’s right and wrong
  • Lies, deceit, and threats
  • Feels above everyone
  • Insensitive, disrespect for others
  • Violent, hostile, irritable
  • Unpredictable
  • Lack of empathy and remorse
  • History of abusive relationships
  • Risk-taker
  • No care for negative results

A diagnosis of ASPD is not made under the age of 18. Even though signs and symptoms of ASPD begin in adolescence, it cannot be confirmed until adulthood. As people get older, destructive and criminal behaviors may decrease.

What Causes Antisocial Personality Disorder?

The cause of ASPD is not entirely understood. But it seems to be caused by hereditary and environmental factors. Children with a parent with ASPD or alcohol use disorder may be at an increased risk.

A history of animal abuse or setting fires as a child is common in ASPD. An antisocial personality disorder is more common in men than in women. About 1% of women and 4% of men suffer from this disorder. ASPD is often seen in prisons and treatment centers.

Is Antisocial Personality Disorder Serious?

Even though ASPD is not discussed as much as other mental health disorders, it is just as dangerous. People with ASPD will put themself in harm’s way. With no care for themself or others. They manipulate people to get their way and are emotionally unavailable. People with ASPD are selfish and will not think twice about breaking the law.

People with ASPD can have a problem keeping a job and a long-term relationship. They are also less likely to obtain a college degree. A large number of people with ASPD are on government assistance and disability.

Family relationships suffer when a person has ASPD. Many individuals only talk to their parents and siblings. Even close friends are unlikely due to manipulation.

ASPD can lead to a higher risk of early death. A study by the National Center for Biotechnology Information (NCBI) shows that people with ASPD are 8.5 times more likely to die early than those with other mental health disorders. The causes for the increased risk include suicide, reckless behaviors, and AUD.

A Dual-Diagnosis: Antisocial Personality Disorder and Alcoholism

It is common for people with an antisocial personality disorder to fight addiction. The occurrence of ASPD in treatment for addiction is higher than the general public. The National Institute on Drug Abuse (NIDA) estimates that 40 to 50% of people in treatment for addiction have ASPD.

The Graduate Journal of Counseling Psychology estimates that almost 90% of people with ASPD suffer from addiction. Those with co-occurring addiction and ASPD may find it difficult in treatment. Many experts believe they are hard to work with due to their manipulative behaviors.

Alcohol Use and Antisocial Personality Disorder

The cause of ASPD is not entirely understood. But, alcohol can be a factor. The use of alcohol changes a person’s brain. These changes can be seen in a person’s behavior.

Alcohol use changes the brain’s neurotransmitters, including gamma-aminobutyric acid (GABA) and serotonin. Both chemicals are linked to aggression and violent outbursts. Because of these behaviors, experts believe ASPD and alcohol use disorder are connected.

People with antisocial personality disorder who drink alcohol can be very aggressive. The use of alcohol increases the reckless and sudden behaviors with no care for safety. Consequences that can result from these behaviors include:

  • Neglect or abuse of spouse or children
  • Mental illness
  • Using a blackout from alcohol as a manipulation tool
  • Low economic status
  • Homelessness
  • Suicidal behaviors
  • Premature death

People with antisocial personality disorder do not realize they are doing anything wrong. They do not feel any of the anxiety, punishment, or any negative feelings. For this reason, people with ASPD may not change their behavior without treatment.

Treatment of Antisocial Personality Disorder and Alcoholism

Personality disorders, such as ASPD can be challenging to treat. But therapies like cognitive-behavioral therapy (CBT), group therapy, and family therapy can be effective treatments for antisocial personality disorder. Treatment for co-occurring ASPD and alcoholism is more complicated.

People with ASPD and alcohol use disorder (AUD) are often court-ordered into treatment. Because they didn’t voluntarily go into treatment, they have issues following a treatment plan and a hard time connecting with a therapist. Individuals with ASPD and AUD do not accept direction from others and often leave treatment early.

Simultaneous treatment for antisocial personality disorder and alcoholism is crucial. A variety of therapies are used in treatment for antisocial personality disorder and alcoholism. Therapies include:

Behavioral Therapy

Just like with other disorders, co-occurring treatment for antisocial personality disorder and alcoholism should happen simultaneously. CBT and contingency management (CM) are effective therapies. CBT raises a person’s awareness of negative behaviors and works to change them. At the same time, CM rewards the right actions hoping to cause repeated good choices.


The FDA has not approved any drugs in the treatment for antisocial personality disorder. There are medications to help with some of the symptoms of ASPD, such as depression and anxiety. The FDA has approved the drugs naltrexone, disulfiram, and acamprosate to help with detox and managing withdrawals in treating alcohol use disorder.

The treatment for antisocial personality disorder and alcoholism should continue for many years. The diseases are chronic and should be treated as such. Support groups such as Alcoholics Anonymous (AA) can be useful in the recovery journey and connecting with others in treatment for antisocial personality disorder.

Treatment of Antisocial Personality Disorder and ALcoholism at Sana Lake

Are you or someone you love suffering from antisocial personality disorder or alcoholism? Our caring team of doctors, therapists, and wellness coaches are waiting to help you build a stable and healthy life. Contact us today and get started on your path to a better life.