The findings of this study suggest that greater emphasis needs to be placed upon the early identification of this hidden population by primary and secondary healthcare personnel, and also ID personnel. Such early identification may also diminish the long-established patterns of use and associated related-behaviours that have been reported within this paper.
There is a dearth of research that has explored alcohol/drug use and misuse by people with intellectual disabilities. The aims of the present study were twofold: (1) to examine the insights of 10 people with intellectual disabilities into the reasons why they may misuse alcohol or drugs, and what impact this behaviour may have on them; and (2) to explore the services that they receive. Ten individuals with intellectual disabilities who were deemed to be misusing alcohol/drugs were purposively selected and interviewed. One overarching theme of the reasons for such misuse was labelled as 'self-medicating against life's negative experiences'. This was divided into two sub-themes: 'psychological trauma' and 'social distance from the community'. All the participants reported that their main source of support came from intellectual disability services, acting in both educational and liaison roles. Although seven of the individuals were referred to mainstream addiction services, they perceived this service as negative. In order to address these underlying problems, better access to a wider range of specialist services is required. Intellectual disability and mainstream addiction service providers also need to be more effective in the prevention and treatment of substance misuse by employing techniques such as motivational interviewing.
Over the 30 years of conflict, Northern Ireland escaped the worst excess of illegal drug trafficking and usage. However, the recent 'peace dividend' has brought with it an unprecedented rise in the availability and use of illicit drugs. With this, new problems and pressures have been brought to bear on the health service. The literature would suggest that drug users are loathed and feared by health care staff. Staff will also admit to be lacking in the knowledge and skills necessary for the delivery of appropriate support and treatment for this client group. Further, the literature has little to offer on the experiences and aspirations of drug users in relation to their treatment and the staff who care for them. In order to understand the drug users' experiences of health care and health staff, focus group methodology was employed to obtain qualitative data. A total of 20 illicit drug users from across Northern Ireland took part. Supporting the literature, all had experienced 'care' that they felt was filled with judgement, hostility and loathing. They recognized clearly the challenge they pose to health care staff. These findings indicate that there is obvious dissonance between those tasked to care for drug users and drug users themselves, with little respect being shown on either side. Results suggest that action needs to be taken to address the deficits in the knowledge, skills and values of health care professionals in relation to illicit drug users. The findings will be of interest to service providers within and outside the United Kingdom.
The literature relating to health professionals and illicit drugs and clients who use them shows many common themes. It is evident that the majority of health professionals hold negative, stereotypical perceptions of illicit drug-users. Consequently, these negative attitudes become prejudicial, hence blocking the professional from carrying out effective and humane nursing care to this client group. Evidence also shows that health professionals' perceptions on the legalization of currently illicit drugs is linked to their own use of these drugs rather than any social or health reasons. Professionals' views on the different illicit substances are also coloured by their use, not by the actual evidence relating to the effects of that drug, in particular, cannabis. The literature shows that health professionals project heavily on to the client all their own negative perceptions of illicit drug use, in the care setting. This has produced very unsatisfactory and unsafe care, resulting in both client and carer being dissatisfied with the whole aspect of care. In addition, specialist teams are being swamped by health professionals who are referring almost every illicit drug-user to these services. The future may be brighter with the generalist and specialist working closely together for the benefit of all, especially the client and, ultimately, the community.
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