Guest Post with Kim Fulda, DrPH, Professor, Executive Director of NorTex, UNT Health
Last month, we talked with Dr. Kim Fulda about substance use disorder (SUD). It can affect people with intellectual and developmental disabilities (IDD).
We’re heading into the holidays. This is a time when people feel stress. It might cause them to start or increase substance use. So this month, Dr. Fulda helps us learn to recognize the signs of substance use in people with IDD. She also tells us what to do if we think someone may be struggling with SUD.
Signs of Substance Use
Substance use can look different for people with IDD. It’s easy to miss the signs. You might think that a behavior or health problem is related to the person’s disability. But it might be a sign of substance use.
Dr. Fulda says we should compare what we see to a person’s usual behavior. If something feels new or strange, it could be a sign of substance use. For example, a person might always want their privacy. But becoming very angry when people intrude might be new. That could be a sign of substance use.
Here are some signs to watch for:
- Sudden behavior changes. The person may seem more quiet, upset, or aggressive.
- New hygiene or health problems. The person might have poor grooming, be sick often, or have unexplained injuries.
- Changes in sleep or eating. Sleeping too much or too little can be a warning sign. So can eating very differently.
- Physical clues. Look for bloodshot eyes. Listen for slurred speech. Pay attention to unusual smells on clothes or breath.
- Medications or alcohol going missing. These could be signs of misuse.
- Lying or secrecy. The person might hide where they go or what they do.
- Money problems or missing things. Substances can be expensive. People might take or sell items to pay for them.
- Loss of functioning. Missing work, classes, or day programs can be a red flag.
- Loss of interest in activities. The person may stop doing things they used to enjoy.
What to Do if You Notice Signs of Substance Use
If you notice these signs, don’t ignore them. People with IDD need understanding and support, not blame or punishment. Here’s what Dr. Fulda recommends:
- Start with care and curiosity. Choose a calm time to talk. You might say, “I’ve noticed you seem different lately. How are you feeling?”
- Listen without judgment. Try not to lecture or react with anger. Many people use substances to cope with pain, loneliness, or stress. They need kindness and support.
- Ask them to seek professional help. Offer to help schedule a doctor or counselor visit. Offer to go with them to the appointment.
- Set clear but kind boundaries. Don’t give them money. Don’t cover up substance use. Focus on safety and connection.
- Get help for yourself. Supporting someone through substance use is stressful. You deserve care too.
Help UNTH Make a Difference!
UNTH’s project will create training and guidelines for health care providers. These will help people with IDD and SUD get better care. People with IDD know best about their lives. So, UNTH wants to interview people with IDD and SUD. Self-advocates will be paid for their time. The interviews will be anonymous. That means no one will know what you say. You won’t be identified by name.
If you want to participate:
- Email Cindy Lopez if you want to take part or have questions.
- Download the flyer for full project information.