Abstract
Abuse of substances by persons with a mild or borderline intellectual disability (IQ 50-85) (ID) is frequently missed, as our cases illustrate. The first client, a 19-year-old man, denied illicit drug use on admittance to a facility for persons with ID. His mood swings, irritability, and fatigue could eventually be attributed to cannabis and cocaine use. The second client, a 35-year old woman with a history of cocaine dependency developed social, financial, and emotional problems. These were first attributed to her ID in combination with borderline personality traits and ADHD. It took a year and a half before these symptoms were recognized as signs of a relapse in the use of cocaine. The third client, a 38-year old woman, referred for recurrent alcohol intoxications, appeared to use other substances as well. Systematic and comprehensive screening for signs of substance use and discussing this issue in an empathetic, non-judgmental manner can contribute to earlier identification and referral to substance use treatment.
