Service Delivery

Treating Substance Use Disorder in Individuals With Intellectual Disability: A Regional System Capacity Assessment.

Eldridge et al. (2025) · Intellectual and developmental disabilities 2025
★ The Verdict

California's referral hubs offer almost no drug treatment tailored for clients with intellectual disability.

✓ Read this if BCBAs who make SUD referrals for adults with IDD in California.
✗ Skip if Clinicians outside California or those not working with substance use.

01Research in Context

01

What this study did

The authors called every regional center and state-vendored drug program in California. They asked: Do you serve clients with both intellectual disability and substance-use disorder? If yes, what do you offer that is different from standard care?

They also asked staff to rate their own training and confidence. The survey took 15 minutes. Ninety-three sites answered.

02

What they found

Only one in five sites had any special plan for clients with IDD. Most offered just physical changes, like wheelchair ramps. None offered evidence-based SUD treatment adapted for cognitive limits.

Staff gave themselves low scores on IDD knowledge. The top barrier was 'no training.'

03

How this fits with other research

Chiviacowsky et al. (2013) already warned that alcohol and tobacco studies for this group were thin. The new data show the gap is still wide open twelve years later.

Wilkinson et al. (2012) found family doctors felt 'overwhelmed' by IDD patients. The same feeling now shows up in drug counselors.

Jackson et al. (2025) tracked Ontario healthcare during COVID-19. Adults with IDD used more services than peers, yet still hit walls. Eldridge et al. (2025) mirror this pattern in California SUD care.

04

Why it matters

If you write a referral for a client with both IDD and SUD, do not assume the local program knows how to help. Ask what they will change: simpler language, shorter sessions, picture schedules, or incentives. Push for a written plan. Until programs add IDD training, you may need to coach them or build the plan yourself.

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Call the next SUD program on your referral list and ask, 'What specific changes do you make for clients with IDD?'

02At a glance

Intervention
not applicable
Design
other
Population
intellectual disability
Finding
negative

03Original abstract

This mixed-methods study assessed substance use disorder (SUD) treatment for individuals with intellectual and developmental disabilities within California's regional center system. The system is the primary organization in California that coordinates and monitors services for these individuals. Data were solicited from the 21 service centers in the system and six vendored programs overseeing SUD services. This article reports on those programs and analyzes qualitative data from seven service coordinators regarding overall SUD treatment. Both the programs and the coordinators identified 0barriers to treatment, such as a lack of training and inadequate service structures. Despite being formal referral targets, these programs often only offered adaptations for physical access. Proposed solutions included interagency collaboration and adopting a biopsychosocial model of care.

Intellectual and developmental disabilities, 2025 · doi:10.1352/1934-9556-63.5.384