Borderline Intellectual Functioning and Drug Addiction

Living on the boundary between intellectual disability and normal intellectual functioning, people with borderline intellectual functioning may struggle to cope with the demands of everyday life. Their cognitive limitations are not enough to qualify as an actual disability, yet they experience many if not most of the same troubles as those with intellectual development disorder, a condition known to cause significant impairment.

Borderline intellectual functioning is linked to an extensive list of life difficulties, including physical and mental health problems, unsteady relationships and unreliable social support systems, and a lack of stable employment and low economic status. It interferes with daily functioning in multiple ways and is associated with chronic anxiety and frustration.

Unfortunately, men and women with borderline cognitive skills are highly vulnerable to substance use disorders. Like others who face ongoing health, financial, and personal problems, they may turn to drugs and alcohol as a way to cope with their stress, unhappiness, loneliness, and poor self-esteem, creating circumstances that can lead to a dangerous slide into chemical dependency.

In any given year, more than 20 million Americans will suffer from drug or alcohol addiction, and about eight million among this group will also experience the symptoms of a bonafide mental health disorder.

This does not include those who have borderline intellectual functioning, which falls short of that standard. But there is an increased risk for substance abuse among this group that mirrors the increase in those with recognized mental health conditions. People with borderline intellectual functioning also face about twice the risk for a mental health disorder as someone with an average IQ, with anxiety disorders being the most common form of mental illness experienced.

Studies indicate that about 13.6 percent of the population, regardless of age group, experience the cognitive difficulties associated with borderline intellectual functioning. Unlike most other mental health problems, borderline intellectual functioning manifests from birth and will always present certain life challenges, even if other co-occurring conditions are addressed in treatment.

A borderline mental disability is not a mental or emotional health disorder. But its disruptive effects mimic, in less severe form, those of intellectual development disorder (IDD), and those who have it face an uphill battle as they attempt to navigate a variety of social, academic, and occupational environments.

The signs of borderline intellectual functioning first appear in early childhood and will continue to reveal themselves in new contexts as a person ages. Some of the common symptoms of borderline intellectual functioning include:

• Delays in speech and learning
• Crawling, sitting up, or walking later than other children
• Poor grades in school
• IQ scores well below average (generally ranging from 70-85, with 100 as the average IQ score)
• Problem-solving deficits in academic and other settings
• Difficulties with memory and knowledge retention
• Impulsivity caused by an inability to determine potential consequences of actions
• Trouble performing on the job or in other environments that are fast-paced, inherently stressful, or closely supervised

People with a borderline mental disability can and do learn, and with occasional outside assistance plus support from the family they can progress in school and in life. Nevertheless, they have real barriers to overcome that can’t be wished away or ignored. In addition to their struggles with some aspects of daily functioning, men and women with borderline intellectual functioning are prone to exploitation by others. They may not always learn from their mistakes and may have a habit of trusting people they shouldn’t.

Substance abuse is one potential consequence of borderline intellectual functioning, and the risks are even greater for those who are exposed to drugs and alcohol during adolescence.

Diagnosing Addiction and Borderline Intellectual Functioning

Clinicians must detect at least three of the following 11 symptoms to diagnose a substance use disorder:

1. Growing tolerance for a substance, marked by a pattern of escalating usage
2. Withdrawal symptoms that appear between dosages
3. Drinking or drug use sessions that last longer or involve greater consumption than planned
4. Multiple failed attempts to stop using drugs or alcohol
5. Significant time spent using drugs or alcohol, obtaining supplies, or recovering from substance use episodes
6. Physical and psychological cravings are experienced
7. Recurrent substance use that causes the person to neglect family, work, school, or personal responsibilities
8. Substance use that continues despite its role in causing social and interpersonal conflicts
9. Favored hobbies and other important activities abandoned in favor of drugs or alcohol
10. Drugs and alcohol used and abused in situations or contexts where it creates physical danger
11. Substance use that continues even though it is implicated in the onset or worsening of mental or physical health problems

Borderline intellectual functioning is not a diagnosable disorder, but it is still recognized as a problematic mental condition by the psychiatric profession. If cognitive issues are clearly disrupting daily functioning and are implicated in other life troubles, such as a pattern of substance abuse, mental health experts will not hesitate to identify borderline intellectual functioning as the problem.

At one point, IQ was an essential aspect of a borderline disability diagnosis. But IQ test results have now been de-emphasized, in favor of a broad assessment that covers the conceptual, social, and practical intelligence domains.

The risk factors for borderline intellectual functioning include:

• Inheritance (family history)
• Genetic abnormalities, such as those associated with Down Syndrome
• Prenatal exposures to trauma or toxins
• Infections at birth or shortly thereafter
• Metabolic problems that cause elevated levels of bilirubin, a chemical produced in the liver
• Malnutrition and other health problems related to parental neglect
• Exposure to child abuse at a very young age
• Coming from a poor socioeconomic background

Addiction is more likely in those who have a family history of drug or alcohol dependency, as well as in those who have a personal or family history of mental illness. Since they often fail to understand all the consequences of their actions, people with borderline intellectual functioning who experiment with drugs or alcohol can be extremely vulnerable to addiction, particularly if they lack strong social support from family and friends.

The Dangers of Overdose

In the United States, more than 64,000 people are now dying of drug overdoses on an annual basis, and a few thousand more succumb to the effects of alcohol poisoning.

Signs of overdose include extreme lethargy and sluggishness, nausea and vomiting, severe disorientation and mental confusion, and a loss of balance and coordination. Unconsciousness and death can result if a drug or alcohol overdose is not treated soon after its symptoms are spotted, and companions of a person demonstrating symptoms consistent with an overdose should call 911 immediately and provide specific information about what substances have been abused.

The latter information is important, since potentially deadly opioid overdoses involving heroin or narcotic painkillers can be reversed through the rapid administration of a drug called Naloxone, which most emergency personnel now carry.

Detox and Withdrawal

People who are addicted to drugs or alcohol may go through a withdrawal period when they stop using their substance of choice. Medically-supervised detox services can help lessen the intensity of this experience, and detox is essential when the addiction is severe (powerful withdrawal symptoms can put sobriety at risk) or involves alcohol (alcohol withdrawal can be fatal in some circumstances).

During detox, patients will recuperate in a fully-staffed clinical facility, with 24-hour supervision and customized treatment services offered as needed. If medications are prescribed to help manage withdrawal symptoms, as they often are when the patient is dependent on opioids or alcohol, dosages will be carefully monitored and tapering procedures may be adopted, if continuing use of these medications is not recommended.

Detox keeps people recovering from chemical dependency safe and secure during the first week or so of recovery, making it a vitally important first step in the healing process.

Addiction is a frequent consequence of mental health troubles, as up to 40 percent of those diagnosed with a drug or alcohol use disorder will also suffer from a mental health disorder.

People suffering from untreated mood, panic, or personality disorders often look for quick and easy ways to manage their symptoms, and drugs and alcohol may seem to provide the relief they seek—at first. If this type of coping behavior continues addiction is likely to develop, and sooner rather than later.

Borderline intellectual functioning is not a mental health disorder, but it increases the odds of a person developing actual disorders. In one study on intelligence and mental health, anxiety disorders were found in about one-third of people with borderline intellectual capacities, while mood disorders were present in about 17 percent of study subjects.

PTSD was the most common disorder uncovered, with nearly 20 percent of study participants exhibiting its symptoms, followed by major depression at nine percent.

When people with borderline intellectual functioning develop substance abuse issues, it is helpful that they get world-class drug addiction treatment for their conditions as soon as possible.

The best inpatient treatment programs for addiction are carefully customized to meet the needs of the individual patient, and that is doubly true for people with intellectual limitations that can affect their capacity to understand their conditions and take consistent action to overcome them.

Dual diagnosis treatment for addiction and borderline intellectual functioning will include full services for chemical dependency, but in a context that caters to the special requirements of someone with cognitive issues. Individual, group, and family therapy sessions will all be included in the treatment program, and family participation can be especially helpful in these cases since people in this position can benefit from the kindness, understanding, and support of their loved ones.

In addition to therapy, life skills and coping skills classes, and holistic healing practices are also important for people with co-occurring substance use and borderline intellectual functioning. Practical strategies for personal growth, impulse control, and emotional management can help these men and women avoid future problems with drugs and alcohol, and this special instruction can show them how to deal with any other symptoms of mental illness they may have been experiencing.

Borderline intellectual functioning is challenging, even without co-occurring addiction and/or mental health disorders. Residential treatment, in a restful, compassionate, supportive environment, can give people in this situation a new lease on life, as they look to build a better future with the able assistance of compassionate healers who truly care.