Service Delivery

Substance use and misuse in persons with intellectual disabilities (ID): results of a survey in ID and addiction services in Flanders.

To et al. (2014) · Research in developmental disabilities 2014
★ The Verdict

Substance misusers with ID carry heavier emotional and life fallout than mere users—catch them early and link services.

✓ Read this if BCBAs working with adults or teens with ID in community or residential settings.
✗ Skip if Clinicians serving only young children or clients with no substance exposure.

01Research in Context

01

What this study did

To et al. (2014) asked staff in Flemish ID and addiction services about clients who have both intellectual disability and substance problems.

They compared two groups: people who only use substances and people whose use already causes clear harm.

The survey looked at mood changes, suicidal thoughts, and other life problems linked to drugs or alcohol.

02

What they found

Misusers faced far worse fallout than users. They had more mood swings, suicidal ideas, and long-term trouble.

Besides that, the two groups looked alike: age, living setting, and support needs were similar.

The data signal that once use turns into misuse, negative effects pile up fast.

03

How this fits with other research

Clarke et al. (2017) later showed that, in the same region, half of adults with mild-moderate ID who live alone currently smoke or drink. Their numbers add local prevalence to Ting’s warning about harm.

Goodwin et al. (2012) scoping review said people with ID have low rates of use but high rates of problems. Ting’s finding that misusers suffer more aligns with that big-picture view.

Lecavalier et al. (2006) in Northern Ireland also surveyed substance-using adults with ID and flagged the same risk profile: male, mild ID, living independently. Ting confirms these factors still matter eight years on.

04

Why it matters

You now know that clients with ID who meet the misuse threshold are the ones in real danger. Screen every new adult intake with brief questions about mood, suicidal talk, and substance fallout. If answers raise a red flag, loop in addiction services right away and write harm-reduction goals into the behavior plan.

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Add two quick intake questions: ‘Have drugs or alcohol caused you mood problems or suicidal thoughts?’ If yes, refer to addiction support and flag for team review.

02At a glance

Intervention
not applicable
Design
survey
Sample size
104
Population
intellectual disability
Finding
positive

03Original abstract

Little is known about the characteristics of substance users with intellectual disabilities (ID). Nevertheless, this group is assumed to be at greater risk of developing substance misuse problems. This study focuses on substance users and misusers with ID, and investigates whether the two groups differ significantly in terms of the nature and consequences of their substance (mis)use. Information regarding the characteristics of the substance (mis)users, the substances used, the negative consequences of substance (mis)use, and the service use was collected through a questionnaire forwarded to ID and addiction services in Flanders. Caregivers identified 104 substance users and misusers with ID. Overall, few differences were observed between users and misusers. This finding underscores that substance use in persons with ID can have important consequences. Substance misusers, however, were found to have more mood changes, more suicidal ideation/thoughts, and more negative long-term consequences on their health, daily activity, and relationships due to substance misuse. Substance use and misuse were associated with mental health problems and were suggested to be a risk factor for offending behavior. To provide appropriate support for this specific population, an individualized approach is suggested that supports better intersectoral collaboration between services.

Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2013.10.015