Problem substance use among people with intellectual disabilities: Challenges to the substance use treatment model

Abstract: Introduction: People with mild intellectual disabilities (MID) have to an increasing extent been described as a high-risk group with regard to problem substance use. This may be associated with the de-institutionalization process that has been going on the recent decades and with an increased concern towards issues related to MID. Although there is seems to be consensus that living in the community is generally more beneficial to people with MID than institutionalization, residential independence is a challenge to some both with regard to lifestyle and affiliation. In addition to adverse health effects, getting abused by non-disabled counterparts, involvement in violence, delinquency etc. tends to accompany the substance use of socially disadvantaged people with MID. People with MID who exhibit such patterns are often marginalized both within in the general population and among more well-adapted MID. Something that adds to the problem load is that MID problem substance users are less likely than problem substance users with higher levels of cognitive functioning to ask for or receive appropriate help. Aim: The aim of the paper is to present both international and relevant Norwegian research literature that could improve Norwegian awareness and practice in the area. Method: We strategically explored both epidemiological and ethnographic research literature published after year 2000 in order to get an overview of prevalence, problem dynamic and recommendations regarding how problem substance use among MID could be prevented or reduced. Results: The conventional treatment model seems inappropriate whereas solutions in the community seem promising. Yet, a prerequisite for increased success is that two conventionally distinct competence areas; namely competence on problem substance use and competence on milieu therapy with intellectually disabled are bridged. Keywords: Problem substance use, intellectual disability, treatment models The paper does not represent any potential conflict of interest.