Transcript Winkel - Tactus Verslavingszorg

Substance use and misuse in Intellectual Disability (SumID)
- Preliminary Results July 2012
Summary
Substance use among persons with mild or borderline Intellectual Disability (ID) was
inventoried in the Netherlands with funding of the Netherlands Organisation for Health
Research and Development (ZonMW)
Interviews were held with hundreds of clients with ID and their professional caregivers. Both
legal and illegal substance use was prevalent. Use of alcohol appears to be lower in the ID
group (compared with Dutch population figures), but use of tobacco and cannabis was more
prevalent. Drugs such as cocaine, XTC, speed, GHB and heroine were also used by a
subgroup. Comparably high numbers of users appeared to have substance related problems.
On the other hand a relatively high percentage persons with ID do not use any substances.
The interviewing method in this research project was feasible and client-friendly. Both the
use of pictures and asking questions on substance related knowledge and attitude, seemed
to evoke a constructive, vivid and informative conversation. Comparison of client report and
analysis of urine- hair- and plaster samples revealed that the interview also renders valid
data on substance use. Caregivers were less accurate in determining whether or not their
client used substances.
This research project shows that persons with ID are a risk group for substance use, and
substance use related problems. Our new interview method provides a framework to assess
substance use, and thus provides a basis for better care.
Results
Results from the validation study:
In the validation study, answers from clients and caregivers were compared with results from
toxicology tests with urine- hair- and plaster samples.
Validity of the SumID Questionnaire has been proven to be good for the client interview.
Additionally, the client interview has proven to be feasible in daily practice, and acceptable
for clients and interviewers. As expected, staff member report on substance use among their
clients showed a much lower concurrent validity with biomarker results.
Results from the population study
With the SumID-Q, a large group of clients with ID in the Netherlands and their caregivers
were interviewd.
Using the SumID-Q we now have information on lifetime, current (last month) and recent
(last days/weeks) use of alcohol, tobacco, cannabis and cocaine, as well as on lifetime use
of other substances. Preliminary results show that lifetime, current and recent use of alcohol
in our research population was lower than in the general population. However use of
tobacco, cannabis and cocaine was higher. Since we had relatively low levels of participation
of the high risk subgroup of independent living adults, prevalence rates found in this may
even be an underestimation of population prevalences
Sociodemographic factors such as age, gender, marital status and occupation Preliminary
results show that users of cannabis were significantly younger than non users, and use of
illicit substances was lower in women. However, alcohol and tobacco use was similar in men
and women in our research population. On group-level, no significant relationship was found
between marital status, living arrangement, daytime activities and substance use. Substance
use was also present in clients who lived in a very sheltered environment.
Using the SumID-Q we measured client knowledge of, attitudes towards and consequences
of substance use as well as readiness to change substance use and consequences of use.
Preliminary results show that users and non-users did not significantly differ in substancespecific knowledge, exept for cannabis users who showed higher substance related
knowledge. As expected, users of all substances were significantly more positive towards
use. Almost 15% of the participants had an AUDIT score of 8 or higher, and about 8% had
an DUDIT score of 6 or higher, indicating problematic use.
This study identified risk factors for substance use, and several risk groups. However,
substance use is also present in other individuals, and clients with these risk factors or in
these risk groups do necessarily use (the same) substances. Hence, though identifying
groups with increased risks for substance use, based on knowledge from this study, is
possible, this does not necessarily provide a group with just substance users.
Joanneke van der Nagel, MD
[email protected]
July 2012