The Experience of Alcohol Use amongst Individuals with an Intellectual Disability in Aotearoa/New Zealand

Background: There is little research literature on alcohol use among those with intellectual and Developmental disability and no New Zealand based studies of such alcohol use prior to this study. Based upon overseas research, alcohol use was associated with a number of co-existing problems such as financial problems, problems with relationships, problems with the police, and problems with mental and physical health. Within New Zealand, alcohol use is normative and the recent movement to community living by people with an intellectual disability potentially places them at increased risk of the adverse effects of alcohol misuse. Aim: The aim of this research project was to investigate alcohol use amongst individuals with a mild intellectual disability in Aotearoa/New Zealand. The project’s focus will be on individuals who have sufficient autonomy to make choices about their alcohol use. The project’s research question is: “What are the experiences with and patterns of alcohol use amongst individuals with a mild intellectual disability living in the community in Aotearoa/New Zealand?” Methodology: The research utilised a critical realist perspective which sees behaviour and experiences as emerging from within, and constrained by, a multi-layered social structure. Semistructured interviews were undertaken to investigate the experience of alcohol use among 10 individuals with an intellectual disability in Aotearoa/New Zealand. The interview transcripts were coded and themes identified utilising Braun and Clarke’s six stage approach to thematic analysis. Results: Three themes were identified: Choices and influences of alcohol use, Context and location of alcohol use and Drinking behaviour. In making choices about alcohol use participants were embedded in a multi-layered social structure which, combined with their disability, constrains their autonomy. Despite these constraints, it is suggested that they were able to exercise valuational agency with respect to their choices regarding alcohol. Consumption levels among participants were generally low, with limited experience of binge drinking or long term adverse effects from drinking. Four protective factors mitigated the risk of pathological alcohol consumption. These were the protective powers of family, social, spiritual, and support networks, learning from negative personal experience, internalisation of rules, and risk aversion. Conclusion: Alcohol use by people with an intellectual disability was found to take place in a highly complex and dynamic social structure. The risk of hazardous use by participants in this study was mitigated by a range of social and individual protective factors