An exploration of substance misuse in people with intellectual disabilities.
Young men with mild ID who live alone and have mental health needs are the group most likely to drink harmfully for years.
01Research in Context
What this study did
Lecavalier et al. (2006) talked to 67 adults with intellectual disability who already used drugs or alcohol. They asked what they used, how long, and what else was going on in their lives.
The team wanted to know who is most likely to keep drinking in a risky way. They looked at age, gender, housing, and mental health.
What they found
Alcohol was the main problem. Many people had drunk in a harmful way for years.
The highest-risk profile was clear: young men with mild ID who live alone and also have mental health needs.
How this fits with other research
Clarke et al. (2017) later asked a similar group in Flanders the same questions. They found the same pattern: about half of adults with mild-moderate ID who live alone currently use tobacco or alcohol. This backs up the 2006 risk picture.
To et al. (2014) went one step further. They showed that people with ID who move from "use" to "misuse" have more mood swings and suicidal thoughts. This means the high-risk group spotted in 2006 faces real harm, not just numbers.
Slayter (2010) looked at a giant US Medicaid file. Only 2.6 % of people with ID had a substance-abuse diagnosis, but most of them had mild ID and depression. The mild-ID link matches Lecavalier et al. (2006), yet the tiny Medicaid rate seems to clash. The gap is likely due to under-recording in billing codes versus face-to-face surveys.
Why it matters
If you serve adults with mild ID who live alone, add one page on alcohol and drug use to your intake packet. Ask every new client, especially young men, about drinking frequency and mood. A quick screen catches the exact risk combo this paper flags before problems snowball.
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02At a glance
03Original abstract
BACKGROUND: Little is known about the characteristics of people with intellectual disabilities (IDs) who misuse substances and how such problems impinge upon their well-being. The aim of this paper is to describe how alcohol and drugs affect the health of people with IDs. METHODS: A questionnaire was forwarded to all the community ID teams and mainstream addiction teams across Northern Ireland: 67 substance users with IDs and substantial substance-related problems were identified. RESULTS: Alcohol was found to be the main substance to be misused, with one-fifth of the substance users also found to be using a combination of illicit drugs and/or prescribed medication. Nearly three-quarters of the sample were found to be hazardously using alcohol for more than 5 years. Being male and young, having a borderline/mild ID, living independently and having a mental health problem were found to be risk factors for developing a 'substance related problem'. Various problematic behaviours were identified, including aggression, erratic mood changes, sexual exploitation, difficulties in maintaining relationships and loss of daily routine. CONCLUSIONS: The findings of this study suggest that greater emphasis needs to be placed upon the early identification of this hidden population by primary and secondary healthcare personnel, and also ID personnel. Such early identification may also diminish the long-established patterns of use and associated related-behaviours that have been reported within this paper.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00820.x