Massachusetts Department of Developmental Services Risk Management 

Subject: Substance Abuse 

What is it?

The term substance abuse is generally considered to refer to the overindulgence in and dependence on drugs and/or alcohol which is detrimental to the individual’s physical and/or mental heath and may negatively impact other people connected with the individual.  Adults with an intellectual disability are subject to the same influences and risks related to substance use as anyone in society; they may be easily influenced by peer pressure, media enticements and family circumstances to drink alcohol or use drugs.  Individuals may also have difficulty recognizing the negative consequences of their substance use, which does not necessarily mean they are in denial of their problem.  

What risk does it present?

Individuals with an intellectual disability suffer a greater risk from the effects of substance abuse due to the likelihood of co-existing medical conditions such as seizure disorders, or cardiac and respiratory problems. These individuals will be negatively impacted by even small amounts of alcohol and illegal drugs. Also by virtue of their disability their limited judgment will be further impaired and most importantly they are likely to be victimized in this negative environment. Even if an individual is not abusing drugs or alcohol, he or she may be used to transport drugs or may be connected with drug users in some manner which compromises his or her safety. 

How is it managed and to whom does this apply?

Any individual who is suspected of having a substance abuse problem and is supported by the Department of Developmental Services should have a risk review by the Area Office risk review team. It is suggested that prior to the review the attached 5 screening questions* be applied by the service coordinator or provider to give insight to the problem 

Information regarding the individual’s status relative to this issue is to be handled in the same manner as any medical information according to HIPAA regulations.

Where can I find additional help?
•	NIH – www.nih.gov
•	NADD – www.nadd.org
•	DPH – www.mass.gov/dph
•	*Annand, Jerry  “More than Accomodation: Overcoming Barriers to Effective Treatment of Persons with Both Cognitive Disability and Chemical Dependency, 2002; s.annand@gte.net

A SIMPLE GUIDE FOR SUBSTANCE ABUSE SCREENING*

1.	The individual uses mood altering-substances ___ yes   _ no 
	How was this identified?
	_____self report   _____provider report   _____observation   _____other
 
2.	The substance(s) used is (are): _______________     legal /illegal_________
 
3.	There is/are problem(s) that could be caused by or could be made worse by the use of the substance(s) ___yes     ___no
 
4.	The consumer has used the substance more frequently and/or more often 	than he/she intended.  ___yes     ___no
 
5.	There have been unsuccessful attempts to control cut back or stop using 
the substance (including previous treatment, promises to “do better,” etc.)  ___yes     ___no
.