Substance use disorders in individuals with mild to borderline intellectual disability: Current status and future directions

• Individuals with ID are at risk for developing substance use disorders.
• Important gaps in our knowledge base on prevalence, screening and treatment remain.
• Daily practice makes insufficient use of new insights from other fields.
• Lines for future research and recommendations for daily care are discussed.

Knowledge regarding substance use (SU) and substance use disorder (SUD) in individuals with mild to borderline intellectual disabilities (ID) has increased over the last decade, but is still limited. Data on prevalence and risk factors are fragmented, and instruments for screening and assessment and effective treatment interventions are scarce. Also, scientific developments in other fields are insufficiently incorporated in the care for individuals with ID and SUD. In this selective and critical review, we provide an overview of the current status of SU(D) in ID and explore insights on the conceptualisation of SUD from other fields such as addiction medicine and general psychiatry. SU(D) turns out to be a chronic, multifaceted brain disease that is intertwined with other physical, psychiatric and social problems. These insights have implications for practices, policies and future research with regard to the prevalence, screening, assessment and treatment of SUD. We will therefore conclude with recommendations for future research and policy and practice, which may provide a step forward in the care for individuals with ID and SUD.