%A Anugu,Vishal %A Ringhisen,John %A Johnson,Brian %D 2021 %J Frontiers in Psychology %C %F %G English %K autism,neurobiological systems engineering,case report,opioid tone,cold pressor test %Q %R 10.3389/fpsyg.2021.657952 %W %L %M %P %7 %8 2021-May-24 %9 Case Report %# %! High Opioid Tone Autism %* %< %T Autism Case Report: Cause and Treatment of “High Opioid Tone” Autism %U https://www.frontiersin.org/articles/10.3389/fpsyg.2021.657952 %V 12 %0 JOURNAL ARTICLE %@ 1664-1078 %X Introduction: Neurobiological systems engineering models are useful for treating patients. We show a model of “high opioid tone” autism and present a hypothesis about how autism is caused by administration of opioids during childbirth.Main Symptoms: Clinical diagnosis of autism in a 25 year old man was confirmed by a Social Responsiveness Scale (SRS) self-rating of 79, severe, and a Social Communications Questionnaire (SCQ-2) by the patient's father scoring 27. Cold pressor time (CPT) was 190 seconds—unusually long, consonant with the high pain tolerance of autism.Therapeutic Intervention and Outcomes: At naltrexone 50 mg/day SRS fell to 54 and SCQ-−2–9; both non-significant. CPT fell to 28, repeat 39 s. Improved relatedness was experienced ambivalently, understood as feelings never before experienced—causing pain. Non-compliance with naltrexone was followed by cutting open his palm and drinking alcoholically. Transference focused psychotherapy has helped him remain naltrexone—compliant while he works on issues of identity and relatedness.Conclusion: The model suggests studies that could be conducted to both prevent and treat this form of autism.