Substance-related and addictive disorders among adults with intellectual and developmental disabilities (IDD): an Ontario population cohort study

Abstract

ObjectivesDescribe the prevalence of substance-related and addictive disorders (SRAD) in adults with intellectual and developmental disabilities (IDD) and compare the sociodemographic and clinical characteristics of adults with IDD and SRAD to those with IDD or SRAD only.DesignPopulation-based cohort study (the Health Care Access Research and Development Disabilities (H-CARDD) cohort).SettingAll legal residents of Ontario, Canada.Participants66 484 adults, aged 18–64, with IDD identified through linked provincial health and disability income benefits administrative data from fiscal year 2009. 96 589 adults, aged 18–64, with SRAD but without IDD drawn from the provincial health administrative data.Main outcome measuresSociodemographic (age group, sex, neighbourhood income quintile, rurality) and clinical (psychiatric and chronic disease diagnoses, morbidity) characteristics.ResultsThe prevalence of SRAD among adults with IDD was 6.4%, considerably higher than many previous reports and also higher than found for adults without IDD in Ontario (3.5%). Among those with both IDD and SRAD, the rate of psychiatric comorbidity was 78.8%, and the proportion with high or very high overall morbidity was 59.5%. The most common psychiatric comorbidities were anxiety disorders (67.6%), followed by affective (44.6%), psychotic (35.8%) and personality disorders (23.5%). These adults also tended to be younger and more likely to live in the poorest neighbourhoods compared with adults with IDD but no SRAD and adults with SRAD but no IDD.ConclusionsSRAD is a significant concern for adults with IDD. It is associated with high rates of psychiatric and other comorbidities, indicating that care coordination and system navigation may be important concerns. Attention should be paid to increasing the recognition of SRAD among individuals with IDD by both healthcare and social service providers and to improving staff skills in successfully engaging those with both IDD and SRAD.

Health Concerns and Health Service Utilization in a Population Cohort of Young Adults with Autism Spectrum Disorder

“…Validated algorithms for these conditions were used in the current study (Gershon et al 2009 ; Hux et al 2002 ; Quan et al 2009 ). The look-back period for diabetes, hypertension, asthma, psychiatric disorders, and substance-related and addictive disorders was 2 years (2007–2009; Lin et al 2016 ).…”

Development and evaluation of a manual for extended brief intervention for alcohol misuse for adults with mild to moderate intellectual disabilities living in the community: The EBI‐LD study manual

“…This premise is enshrined in the Equality Act () but also has been the cornerstone of government policy which strongly advocates the use of universal health services by people with intellectual disability (Department of Health, , ). Recent studies have shown that people with intellectual disability are vulnerable to a number of mental health conditions such as common mental disorders, psychosis and dementia (Cooper, Smiley, Morrison, Williamson, & Allan, ; Lin et al., ) as well as substance use disorders (Van Duijvenbode et al., ).…”

“…Despite the sparse literature regarding substance misuse in people with intellectual disability there is increasing interest in studying such problems because most people with intellectual disability now live in the community and are likely to be exposed to substances in their social networks as well as consuming them (Lin et al., ; Miller & Whicher, ). UK and USA population‐based studies indicate that the prevalence of substance misuse in people with intellectual disability ranges from 0.5% to 2.5% and may be as high as 22.5% for any substance in clinical samples (Cooper et al., ; Hassiotis et al., ; McGillicuddy & Blane, ; Pezzoni & Kouimtsidis, ; Sturmey, Reyer, Lee, & Robek, ).…”

“…Alcohol and cannabis are the commonest substances that people with mild to moderate intellectual disability use. Those most at risk are young males with mild intellectual disability or borderline intellectual functioning (defined as IQ between 1 and 2 standard deviations below the mean) who live independently, in poorer neighbourhoods, with minimal support in the community and are less likely to engage in social activities (Barrett & Paschos, ; Lin et al., ).…”

Important Research Priorities in Intellectual Disability in India: A Public Health Perspective

“…The same trends are already occurring in developed countries, with rising risk and prevalence of substance abuse among ID people. [ 8 9 ] Currently, the prevalence and risk for substance use and abuse among ID people in India are unknown, highlighting the need for efforts to identify and map the epidemiological profiles of the behavior and the indicated correlated conditions early.…”