Antisocial Personality Disorder & Alcohol

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Are you, or someone you love, struggling with an Antisocial Personality Disorder (ASPD) diagnosis? Any personality disorder can be challenging as the symptoms are associated with rigid, negative characteristics that often include aggressive or destructive behaviors. However, ASPD is a particularly troubling diagnosis to receive. 

Many people are more familiar with the term sociopath than Antisocial Personality Disorder. Doctors do not diagnose individuals as a sociopath, but traits of sociopathy and ASPD do overlap. Typically, a lot of attention is given to individuals with this label. People identified as a sociopath may be well known for their cruel, violent behaviors and lack of remorse toward their victims. The confusing aspect of ASPD is that most people can be charming and engaging during social interactions. How can someone who seems so delightful also be cold, manipulative, and lack empathy toward others? 

Another alarming fact about ASPD: The prevalence of alcohol-use disorder and ASPD is 68%.

In addition to understanding more about ASPD and possible treatment options available, we will also identify the relationships between alcohol use and ASPD. Why the two disorders commonly occur and why it is necessary to seek treatment for the dual diagnosis.  

If you or someone you love is diagnosed with ASPD and are struggling with alcohol use, you don’t have to navigate this alone. Guardian Recovery has an extensive team of experts treating mental health and alcohol-use disorders. Contact us today to assess what treatment options are available. Speak with a treatment advisor for an individualized treatment plan for you or a family member in need. 

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What is Antisocial Personality Disorder (ASPD)?

Antisocial Personality Disorder is a mental health disorder primarily characterized as an enduring, engrained pattern of disregard for others. 

Although symptoms may emerge in childhood (typically diagnosed as a Conduct Disorder), Antisocial Personality Disorder can not be diagnosed in children or adolescents due to the nature of personality evolving. 

Common Characteristics of ASPD:

  • Breaking the rules or law.
  • Behave aggressively or impulsively. 
  • Feeling little guilt or remorse for harming others. 
  • Use manipulation, deceit, or control over others. 

Common Symptoms of ASPD:

  • Anger. 
  • Arrogance. 
  • Manipulating others.
  • Acting witty/charming to get what they want.
  • Lying frequently. 
  • Stealing.
  • Acting aggressively/fighting often.
  • Breaking the law.
  • Not caring about others’ safety.
  • Not showing guilt or remorse for actions. 

Do People Drink Alcohol to Cope with Antisocial Personality Disorder?

Alcohol is typically associated with co-occurring mental health disorders because many people use alcohol to numb, avoid, and repress problems triggered by mood disorders such as depression, anxiety, or post-traumatic stress disorder. However, research indicates other reasons why comorbidities of ASPD and alcohol-use conditions commonly exist. Antisocial Personality Disorder is associated with two traits, anger and impulsiveness. Research suggests that impulsive and anger traits are triggering the use of alcohol, not the overwhelming desire to cope with the distress of mental illness. 

Additionally, the linkage between alcohol use and ASPD is significant. This research article has shown that a person is 21 times more likely to develop alcohol dependence when diagnosed with ASPD than someone who does not have the diagnosis.

It is believed that a person with ASPD may have a genetic predisposition to both alcohol-use disorder and ASPD due to the high comorbidity of both diseases. Research has indicated that a genetic marker, HTR1B at 6q13-15, predisposes antisocial personality disorder and alcoholism.

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How Does Alcoholism Affect Antisocial Personality Disorder?

Knowing that alcohol can increase inhibition, impulsivity, and emotional regulation is a bad combination to add to a disorder that primarily consists of anger, lack of regard for others, and a thrill to engage in violence. 

research article also indicated that individuals with ASPD had a higher incidence of alcohol-related aggression than people without ASPD.  This statistic suggests that alcohol escalates the traits of anger and aggression, which may contribute to the high prevalence of ASPD and alcohol. 

In addition, due to the severity of symptoms, people who use alcohol are at a higher risk of engaging in criminal acts, such as physical acts of destruction, sexual assault, child abuse, and homicide.

Treatment for Antisocial Personality Disorder and Alcoholism

Treatment for personality disorders can be incredibly challenging to treat. Most individuals with a diagnosis of ASPD rarely admit they have a problem, need help, or are willing to seek treatment. Because they lack empathy or remorse for others, they don’t have the internal motivation to change. 

Most often, treatment is mandated by the courts for a person with ASPD. Maintaining therapy can also be challenging as the client may self-sabotage and avoid taking the therapist seriously. 

However, family members struggling to help a person they love seek treatment don’t give up. If you have difficulty encouraging a loved one to recognize their alcohol use is a problem, here are some resources for you. 

If a person with ASPD agrees to engage in therapy, they must treat the co-occurrence of alcohol addiction and their personality disorder. Additionally, safety concerns often require a higher level of care, such as residential inpatient treatment

Treatment Approaches for AUD & ASPD:

  • A thorough assessment of mental health and alcohol/substance use disorders.
  • Medical detoxification.
  • Residential inpatient treatment. 
  • Holistic treatment focuses on physical, mental, emotional, spiritual, and social factors.

Treatment for the personality disorder should be an evidence-based therapy such as Dialectical Behavioral TherapyEMDR, or CBT. People who have developed a Personality Disorder have often also experienced childhood trauma. These therapies are particularly effective in treating trauma, improving interpersonal relationships, and learning healthy ways to regulate emotions. 

Once a person has gone through residential inpatient and medical detoxification for alcohol addiction, seeking ongoing treatment for alcohol use will help increase recovery success. 

Guardian Recovery provides excellent treatment options for individuals with dual diagnoses of alcohol addiction and mental health disorders. A step-down approach in treatment allows a person to receive various levels of care for each phase of recovery. A person may start in residential inpatient, move to partial hospitalization, step down to intensive outpatient, and then fade to outpatient or attend regular support meetings. We recognize that every person is unique, and each treatment plan is customized to fit one’s individual needs for their journey toward wellness. 

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Do you, or someone you love, have a diagnosis of Antisocial Personality Disorder and are worried about alcohol use? As both disorders increase the risk of assault or violence,  it is recommended that you seek treatment immediately. 

At Guardian Recovery, we believe it is essential to treat the whole person. Through holistic therapies, we can address a person’s needs by looking at the physical, mental, emotional, spiritual, and social aspects of a person’s life. We have developed a comprehensive recovery program to focus on all areas of health and wellness during a person’s recovery. 

In addition to a free telephone assessment to evaluate your needs, we also can provide a no-obligation insurance benefit check at your convenience. 

You don’t have to navigate this journey alone. Contact us today to begin hope and healing. 


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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