Substance Abuse and Intellectual Disabilities

Basic Information about Substance Abuse

• More than 90% of the people who struggle with substance abuse began experimenting with smoking, drinking, and other drugs before the age of 18.
• In 2017, 19.7 American adults struggled with a substance abuse.

Basic Information

Founding Father of America

Rush challenged the accepted belief at the time that alcoholism was a moral failing, thereby progressing the concept of addiction as a disease.

• Addiction was treated as a criminal offense
• Intensive faith-based prayer
• Even mental institutions

This signified a shift to viewing addiction as an illness that could be managed

Benjamin Rush

5 Steps for an individual with ID and has SUD

5 steps

• 1. Perform Screening tests

- Unfortunately, no substance use screening tests are validated specifically for patients with ID.

• 2. Use approved medications to treat SUDs.

-Medication-assisted treatment is under prescribed for patients with ID.

• 3. Make a thorough assessment before recommending Alcoholics Anonymous or Narcotics Anonymous meetings

-While the 12-step recover model has proven benefits, typical structure of 12-step meetings is not conducive to all patients with ID.

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• 4. Employ motivational interviewing

- Many patients with ID have cursory knowledge of health risks associated with substance abuse, particularly those with mild ID.

• 5. Provide ongoing support

- Remember that addiction is a chronic disease with risk of relapse.

5 steps continued

Substance abuse within the ID population can lead to...

ID population

• Increased social isolation
• Problems with the criminal justice/court system
• Victimization while under the influence
• Increased cognitive problems
• Poor impulse control
• Health problems related to substance abuse, and even death
• Life - threatening side effects from interactions with other medications

Picture

Explain

Picture down below

That picture below is more on autism spectrum disorder, specially on Asperger Syndrome.

Surveyed more likely to:

• Abuse nicotine
• Abuse alcohol
• Abuse marijuana

-Also the ones diagnosed with autism with more severe side of the spectrum were less likely to abuse these substances.

Example

• People with ADHD and other disabilities who are medicated with stimulants and amphetamines should avoid any substance use due to the many dangers associated with mixing drugs.
• Additional using like:
• Cocaine increases the risk of severe side effects and overdose.
• There have been a few isolated cases of young people on medications like Adderall suffering sudden heart failure resulting in death.
• Use of alcohol, barbiturates, and other substance:
• Depress the nervous system and stimulants can mask symptoms of overdose, cause other complications and increase the risk of seizures.

Dangers

Dangers

• Many intoxicating substances also cause reduced inhibitions, impulsive or destructive behavior, and sudden mood changes, especially if the individual is dependent on the drug.
• Side effects: Can exacerbate existing issues that many people with intellectual disabilities have.
• The unpleasant sensations associated with "coming down" from a high or from withdrawl can be especially distressing for these individuals, making it much harder to stop using drugs.

Dangers

• Difficulty communicating can cause frustration and temptation to lash out.
• Confusion and poor coordination are also typically worsened by substances like alcohol, increasing the chance of injury.
• Increased social issues are also a concern when an intellectually disabled person is engaging in substance abuse.
• The results of this behavior can make it even more difficult to get medical appointments, therapy and group counseling sessions, social or family events.
• Drug abuse may strain relationships between individuals and caretakers, leading to a greater risk of isolation, depression, and anxiety.

Dangers

• Those who have an intellectual disability (ID) has often been experiencing more negative affects from a substance use disorder (SUD) compared to patied without ID.
• "Heightened risk for developing SUD is thought to result from risk factors in individuals with IDD, like adverse life events and inadequate coping strategies, as well as risk factors associated with IDD, such as the desire to "fit in" and increased susceptibility to peer pressure."
• Caregivers that work with people with ID state that they have a lack of knowledge and skills to work with clients with SUD.
• "79% of the respondens reported lack of expertise, including being inadequately equipped to meet the client's needs and to develop effective policies to reduce SUD."
• (VanDerNagel, J. E. L., 2018, p. 55)

Video

Modified AA Group

- In some states, they are creating groups for individuals that are modified from the AA group

- Similar to AA in a way that they emphasize being capable and empowered to make changes in ones life

- Not a 12 step program, but rather a program where you can go to talk if able and learn how to be self dependent when struggling vs turning to drugs/alcohol

Modified AA

Counselors working with individuals will...

Counselor

• ask simple questions, repeat if necessary
• teach refusal skills
• avoid generalizing, don't say that the same skill can be used in two places
• have the individual repeat back a concept to make sure they understand
• utilize role - playing
• have the individual focus on specific goals
• address trauma in psychotherapy if there is an issue present

"Recovery is an ongoing process, for both the addict and his or her family. In recovery there is hope. And hope is a wonderful thing."

Dean Dauphinais

• Slayter, E.M. (2009). Identifying substance abuse among clients with intellectual disabilities: Don't rule it out before you rule it out! The New Social Worker, 16(3). 27-28.
• Carroll Chapman, S.L. & Wu, L.T. (2012). Substance abuse among individuals with intellectual disabilities. Research in Developmental Disabilities, 33. 1147-1156.

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