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The article offers information on a study on disparities in substance abuse treatment utilization among women with intellectual disability. Topics discussed include women entering substance use disorder treatment have severe medical and psychiatric problems; and lack of access to treatment due to poor insurance coverage and substance-abuse-related stigma.

Access to substance abuse treatment is a noted concern for people with disabilities. Although much is known about elders with dual eligibility for Medicaid and Medicare regarding any care utilization and expenditures, little is known about their younger counterparts and how substance abuse might contribute. Drawing on national Medicaid claims, treatment utilization was explored for adults with and without dual eligibility for Medicare. People with dual eligibility were less likely to both initiate and engage in treatment as compared to those without dual eligibility. Implications relate to how existing systems provide substance abuse treatment to people with disabilities. [ABSTRACT FROM AUTHOR]

For some, community inclusion facilitates access to alcohol and drugs and, therefore, the potential for developing substance abuse disorders. However, little is known about substance abuse treatment use among people with intellectual disabilities. Using standardized performance measures, substance abuse treatment utilization was examined for Medicaid-covered people with intellectual disabilies and substance abuse (N = 9,484) versus people without intellectual disabilies (N = 915,070). The sociobehavioral model of healthcare use guides multivariate logistic regression analyses of substance abuse treatment utilization patterns, revealing disability-related disparities. Factors associated with utilization included being non-White, living in a nonurban area, having a serious mental illness, and living in a state with a generous Medicaid plan for substance abuse treatment. Implications relate to health policy, service delivery patterns, and the need for cross-system collaboration in the use of integrated treatment approaches. [ABSTRACT FROM AUTHOR]

People with intellectual disabilities (ID) have experienced increasing levels of community participation since deinstitutionalization. This freedom has facilitated community inclusion, access to alcohol and drugs, and the potential for developing substance abuse (SA) disorders. People with ID, who are known to have high rates of co-occurring serious mental illness (SMI), may be especially vulnerable to the consequences of this disease and less likely to use SA treatment. Using standardized performance measures for SA treatment access (initiation, engagement), rates were examined retrospectively for Medicaid beneficiaries with ID/SA/ SMI ages 12 to 99 (N = 5,099) and their counterparts with no ID/SA/SMI (N = 221,875). Guided by the sociobehavioral model of health care utilization, age-adjusted odds ratios and logistic regression models were conducted. People with ID/SA/SMI were less likely than their counterparts to access treatment. Factors associated with initiation included being nonwhite, living in a rural area, and not being dually eligible for Medicare; factors associated with engagement included all of the same and having a fee-for-service plan, a chronic SA-related disorder, or both. Social work policy and practice implications for improving the health of people with ID/SA/SMI through policy change, cross-system collaboration, and the use of integrated treatment approaches are discussed. [ABSTRACT FROM AUTHOR]

People with mental retardation (MR) and addiction are an especially vulnerable population, yet evidence-based approaches to substance abuse (SA) treatment for this group are limited. Research suggests that SA-related services for this population are most likely received in nonaddiction settings that are generally focused on provision of mental health services to populations with MR and that might be unequipped for this work. This fact, combined with documented challenges to cross-system collaboration, suggests the potential for discontinuities in care for people with MR and SA. Recommendations for SA screening and a framework for cross-system collaboration are presented with specific recommendations for the ways in which social workers in both MR and SA service settings can promote positive client outcomes. [ABSTRACT FROM AUTHOR]

People with mental retardation have experienced increasing levels of freedom and access to community living over the past 40 years. This has included access to alcohol, illicit drugs and the potential for developing substance abuse and related problems. The manner in which people with mental retardation have handled this access has been recognized since the de-institutionalization era began. Despite this recognition, documented barriers to accessing substance abuse treatment tbr people with mental retardation exist and there is an overarching lack of knowledge about accessible treatment approaches for this population. Policy and practice recommendations are presented for disability and rehabilitation social workers in order to better understand and combat barriers to substance abuse treatment. [ABSTRACT FROM AUTHOR]

Substance abuse (SA) is a documented issue for many people with mental retardation/developmental disabilities (MR/DD). However, little empirical data exist regarding the appropriateness or effectiveness of prevention or treatment approaches for this population. Compounding this issue, access to SA treatment for this population is also limited, making social work case management a challenge. For social workers, the problem of SA among people with MR falls into a gray area between the facilitation of the "dignity of risk" and risk management. Discussions of Deborah Stone's commentary on balancing liberty, equality, and security in social policy are presented in light of ways to encourage the implementation of the "dignity of risk." Linking theory to practice, a baseline framework is provided for planning individualized, self-determination-oriented case management approaches for people with SA who have MR. [ABSTRACT FROM AUTHOR]