Suchttherapie 2011; 12 - S17_2
DOI: 10.1055/s-0031-1284556

Substance use and misuse in Dutch Disability Services – An exploration of Staff members' perspective

J Van der Nagel 1
  • 1Tactus, Enschede, Nederland

The use of psychoactive substances seems to be a growing problem among clients of Intellectual Disability Services (IDS). However, rates of substance use in Dutch IDS are unknown, and it is unclear how services deal with these issues. We explored staff members’ perspective on substance use, users’ profiles, and service policies. Method: A semi-structured questionnaire asked respondents to comment on lifetime, current and problematic substance use among their clients, provide case reports, and describe policies regarding substance related problems. Findings: Data from 39 IDS were included. Estimations of occurrence of substance use varied greatly across services. Alcohol was reported to be used most often, but in lower percentages than in the general population. Cannabis and other drugs were reported to be used relatively often when compared to the general population. Case reports on 86 substance users were analyzed. Subgroups of users were identified including a group of younger clients with both cannabis and alcohol use, and a group of older clients with mild ID using alcohol only. Psychiatric comorbidity and lack of daytime activities were highly prevalent among cases. Services reported on their interventions and policies concerning substance use, rating psychosocial and restrictive measures as most effective, and collaboration with addiction facilities and rewarding abstinence as least effective. Most services reported to have inadequate expertise on substance use. Conclusions: According to respondents, clients with both borderline and mild ID use substances. Case reports suggest different patterns of use across age groups and level of ID, and indicate a number of other psychosocial problems. Respondents report to be inadequately equipped to meet clients’ needs and to develop effective policies. The low effectiveness of mainstream addiction treatment or consultation suggests that there is a need for more cross-system collaboration.

Literatur: Degenhardt, L. (2000). Interventions for people with alcohol use disorders and an Intellectual Disability: A review of the literature. Journal of Intellectual & Developmental Disability, 25, 135-146. Geus R, Kiewik M, VanderNagel J, Sieben G, (2009). Substance use among persons with Intellectual Disability [Verstandelijk gehandicapten en verslavingsproblematie], In: C. Loth , R. Rutten (Eds). Addiction, Handbook for treatment, care and prevention [Verslaving, Handboek voor zorg, begeleiding en preventie] (pp. 313-323) Amsterdam: Elsevier. McLaughlin, D.F., Taggart, L., Quinn, B. Milligan, V. (2007) The experiences of professionals who care for people with Intellectual Disability who have substance-related problems. Journal of substance Use, 12, 133-143. McGillicuddy, N. B. (2006). A review of substance use research among those with mental retardation. Mental Retardation & Developmental disabilities research reviews, 12, 41-47. Taggart, L., McLaughlin, D., Quinn, B., & Milligan, V. (2006). An Exploration of Substance Misuse in People with Intellectual Disabilities. Journal of Intellectual Disability Research, 8, 588-597 VanDerNagel, JEL, Kiewik, M, Buitelaar, JK, DeJong, C (submitted). Substance Use and Misuse in Dutch Disability Services - an Exploration of Staff Members' Perspective