Addictions

Addictions

Screen for risk factors

Screen for risk and vulnerability factors for addictions as part of a comprehensive health assessment.321

Strongly Recommended

Empirical Ecosystem Expert

Addictions are underrecognized among adults with IDD.317 High risk of addiction is associated with mild IDD, persons who live independently, males, those with psychiatric disorders, and those with legal issues.318 The most commonly used substance is alcohol 319, 320, followed by cannabis.320 Lower amounts of alcohol consumed can lead to functional impairments relative to the general population.318, 319

Educate adults, family and caregivers

Educate adults with IDD, family, and other caregivers regarding risks and vulnerabilities, including peer pressure and exploitation.322

  Strongly Recommended

Empirical Ecosystem Expert

Addictions are underrecognized among adults with IDD.317 High risk of addiction is associated with mild IDD, persons who live independently, males, those with psychiatric disorders, and those with legal issues.318 The most commonly used substance is alcohol 319, 320, followed by cannabis.320 Lower amounts of alcohol consumed can lead to functional impairments relative to the general population.318, 319

Review the person’s environment, relationships and supports

When addiction is present, review the person’s environment, social relationships, and supports. Understanding how aware the person is of the problems and the associated risks can assist in developing appropriate interventions.322, 323

  Strongly Recommended

Empirical Ecosystem Expert

Addictions are underrecognized among adults with IDD.317 High risk of addiction is associated with mild IDD, persons who live independently, males, those with psychiatric disorders, and those with legal issues.318 The most commonly used substance is alcohol 319, 320, followed by cannabis.320 Lower amounts of alcohol consumed can lead to functional impairments relative to the general population.318, 319

Use a harm reduction approach

Work with the person, their family and other caregivers using a harm-reduction approach, including planning regular office visits.318

  Strongly Recommended

Empirical Ecosystem Expert

Addictions are under-recognized among adults with IDD.317 High risk of addiction is associated with mild IDD, persons who live independently, males, those with psychiatric disorders, and those with legal issues.318 The most commonly used substance is alcohol 319, 320, followed by cannabis.320 Lower amounts of alcohol consumed can lead to functional impairments in this population.318, 319

Advocate adaptations and additional supports

Advocate for adaptations to and arrange additional supports for people with IDD in order to benefit from generic addiction-related services designed for people without IDD.321, 325 Promote opportunities for meaningful socialization that do not involve exposure to addictive substances.

  Strongly Recommended

Ecosystem Expert

There are few addiction-related services adapted to the needs of people with IDD.324 They are very likely to have comorbid psychiatric diagnoses and a range of physical health issues that require a multifaceted approach to management.317, 318

317. Lin E, Balogh R, McGarry C, Selick A, Dobranowski K, Wilton AS, et al. Substance-related and addictive disorders among adults with intellectual and developmental disabilities (IDD): An Ontario population cohort study. BMJ Open. 2016;6(9):e011638,2016-011638.

318. van Duijvenbode N, VanDerNagel JE, Didden R, Engels RC, Buitelaar JK, Kiewik M, et al. Substance use disorders in individuals with mild to borderline intellectual disability: Current status and future directions. Res Dev Disabil. 2015;38:319-28.

319. Pezzoni V, Kouimtsidis C. Screening for alcohol misuse within people attending a psychiatric intellectual disability community service. J Intellect Disabil Res. 2015;59(4):353-9.

320. To WT, Neirynck S, Vanderplasschen W, Vanheule S, Vandevelde S. Substance use and misuse in persons with intellectual disabilities (ID): Results of a survey in ID and addiction services in flanders. Res Dev Disabil. 2014;35(1):1-9.

321. Taggart L, Chaplin E. Substance misuse. In: Tsakanikos E, McCarthy JM, editors. Handbook of psychopathology in intellectual disability: research, practice, and policy. New York: Springer; 2014. p. 205-23.

323. Slayter E, Steenrod SA. Addressing alcohol and drug addiction among people with mental retardation in nonaddiction settings: A need for cross-system collaboration. J Soc Work Pract Addict. 2009;9(1):71-90.

324. Slayter EM. Understanding and overcoming barriers to substance abuse treatment access for people with mental retardation. J Soc Work Disabil Rehabil. 2008;7(2):63-80.

325. Day C, Lampraki A, Ridings D, Currell K. Intellectual disability and substance use/misuse: A narrative review. Journal of Intellectual Disabilities and Offending Behaviour. 2016;7(1):25-34.

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