Barriers and opportunities in substance use disorder treatment for individuals with intellectual and developmental disabilities: Provider perspectives and system gaps in Texas.

Background

People with intellectual and developmental disabilities (IDD) are susceptible to substance use disorders (SUD) due to social determinants of health and risk factors such as impulsivity, social isolation, and efforts to fit in.

Objective

We sought to collect and describe SUD treatment for people with IDD from the provider perspective.

Methods

We conducted qualitative interviews and one focus group with participants (N = 17) who responded positively to an emailed invitation. Participants worked for substance use treatment agencies in Texas. We conducted a thematic analysis of the transcripts using three coders who reached consensus regarding the analysis.

Results

Participants (N = 17) represented a range of roles in SUD treatment settings, including clinic administrators (29%), treatment providers (53%), and peer specialists (18%). Analysis of transcripts identified five overarching themes related to SUD treatment for people with IDD: limited screening tools for identifying IDD at intake; tailored, informal accommodations that improve engagement; systemic and structural barriers to treatment initiation and adherence; the caregiver's role as an essential but underutilized partner; and gaps in provider training.

Conclusions

Providers working with people with IDD in SUD treatment agencies reported significant gaps in screening, treatment adaptation, and training that affect care for this population. These findings underscore the need for standardized IDD screening tools, targeted provider training, and policies supporting caregiver involvement and individualized treatment planning to improve access to and quality of care for people with IDD.