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Substance Use Among Individuals With Developmental Disabilities in Ontario

Applied Health Research Question submitted to H-CARDD by the Centre for Addiction and Mental Health, Toronto
Authors: Caitlin McGarry, Avra Selick, Kristin Dobranowski, Andrew Wilton, Robert Balogh, Yona Lunsky, & Elizabeth Lin

Background

There is little information in the literature on substance use in adults with developmental disabilities. What literature there is suggests that individuals with developmental disabilities who use substances are more likely to be young, to be male, and to have mild disabilities than those with developmental disabilities who do not use substances. The literature had also found that although rates of substance use in individuals with developmental disabilities are lower than those in the general population, individuals with developmental disabilities are at high risk for negative consequences as a result of substance use. However, these findings are based on very small studies.

Purpose

The purpose of this report was to a large administrative database to describe the prevalence of substance-related or addictions disorder among adults with developmental disabilities.

Methods

Using health and social services administrative data from the Institute for Clinical Evaluative Sciences and the Ontario Ministry of Community and Social Services, 66,484 adults with developmental disabilities aged 18 to 64 years (in 2009) were identified.

Findings

  • Individuals with substance-related or addictions disorder represented 6.4% of Ontario adults with developmental disabilities. This figure is more than twice as high as previously reported in the literature (0.05-2.5%) and is also higher than comparable results for persons without developmental disabilities (3.5%) and the general Canadian population (4.4%).
  • The vast majority (78% of the 6.4%, or 5.0%) also had a concurrent mental illness; the remaining 1.4% had developmental disabilities and substance-related or addictions disorder only.
  • Individuals with developmental disabilities and a substance-related or addictions disorder (whether concurrently with a mental illness or not) were more likely to be male compared to those with developmental disabilities and mental illness (but no substance-related or addictions disorder).
  • They were also more likely to live in neighbourhoods in the lowest income quintile compared to those with developmental disabilities and mental illness (but no substance-related or addictions disorder). This suggests a strong relationship between substance use and socioeconomic status.
  • They were also more vulnerable than other subgroups to a range of chronic diseases, in particular asthma and chronic obstructive pulmonary disease.

Conclusions and Implications

Substance-related or addictions disorder is an important concern for adults with developmental disabilities. It is associated with poorer determinants of health and higher risk of comorbid physical and mental health problems. Incorporating this information into policy and service delivery planning for adults with developmental disabilities in Ontario should be considered.