LAUSR

During the past decade, the topic of substance use and abuse by individuals with mild intellectual disability or borderline ntellectual functioning (MID-BIF; DSM-IV-TR, IQ 50–85) has received increasing attention in the literature as well as in linical practice. Substance use, especially the use of alcohol and tobacco, is widely spread in society, and is related to social onventions both for individuals with and without MID-BIF (Van Duijvenbode et al., 2015). Although not all substance use eads to adverse consequences, individuals with MID-BIF have been identified as a group at risk for negative consequences f the (ab) use of substances such as tobacco, alcohol, cannabis, and other drugs. The (ab)use of substances may have a ange of somatic, psychological and social adverse consequences for these individuals, such as mental and somatic health roblems, problems concerning daily activities and relationships, and offending (see e.g., Lindsay et al., 2013; To, Neirynck, anderplasschen, Vanheule, & Vandevelde, 2014). Even though individuals with MID-BIF are increasingly recognized as a risk group for substance use disorders, still little s known about its prevalence and risk or protective factors. Until present, reliable data on prevalence on substance (ab)use n individuals with MID-BIF are lacking. This is not surprising given the challenges associated with assessing such rates, ncluding: (1) definition of MID-BIF group (inor excluding those with borderline intellectual functioning – IQ 70–85) or ubgroups (such as those with co-occurring mental health disorders), (2) definitions and scope (inor excluding use of obacco and/or prescribed medication) of substance (ab)use, (3) measurement issues (e.g., lack of valid instruments), and 4) problems associated with stigma and denial of substance related problems (by both users and their caregivers). Also, (5) revalence rates may have increased in recent years possibly due to increased integration in the community, or – alternatively due to increased awareness and attention by caregivers to such problems. Finally, it is likely that (6) differences between ountries in socio-economical factors, ID care and addiction treatment facilities and alcohol and drugs-related policies and egislation account for differences in prevalence rates among those with ID (Didden, VanDerNagel, & Van Duijvenbode, 2016; an Duijvenbode et al., 2015). Several reviews have shown that the evidence-base on the feasibility and effectiveness of interventions is still small see Didden et al., 2016; Kerr, Lawrence, Darbyshire, Middleton, & Fitzsimmons, 2013). Kerr et al. identified only 9 articles ublished between 1996 and 2011, most of which were of poor to moderate methodological quality in terms of design, eliability, sample size and description of procedures. Didden et al. concluded that only a small range of different interention approaches (i.e., psycho-education, motivational interviewing, cognitive behavioral therapies) have been used in he treatment of substance (ab)use in individuals with ID. In all cases, interventions were adapted – through e.g. simplified anguage, use of pictorial stimuli – to the needs of individuals with MID-BIF. These interventions were mostly implemented or reducing substance (ab)use in participants and no conclusions could be drawn on which elements contributed to the ffectiveness of an intervention. Alcohol and/or tobacco were targeted most often. As far as we know, interventions targeting llicit drugs or prescribed medications have not been reported in the literature. To be able to provide effective care and treatment, adequate recognition and assessment of both substance (ab)use and ID-BIF is warranted. This includes both identifying individuals with MID-BIF in addiction care (see e.g., To et al., 2014) as