Substance Abuse and Mental Retardation: Balancing Risk Management with the “Dignity of Risk”

Substance abuse (SA) is a documented issue for many people with mental retardation/developmental disabilities (MR/DD). However, little empirical data exist regarding the appropriateness or effectiveness of prevention or treatment approaches for this population. Compounding this issue, access to SA treatment for this population is also limited, making social work case management a challenge. For social workers, the problem of SA among people with MR falls into a gray area between the facilitation of the “dignity of risk” and risk management. Discussions of Deborah Stone's commentary on balancing liberty, equality, and security in social policy are presented in light of ways to encourage the implementation of the “dignity of risk.” Linking theory to practice, a baseline framework is provided for planning individualized, self-determination-oriented case management approaches for people with SA who have MR.