Prevalence Of Substance Abuse In Disabled Individuals
In 2016, roughly 12.8 percent of Americans, or 40,890,900 individuals, struggled with a disability. Certain studies anticipate that as high as four out of ten disabled persons experience substance abuse in some way.
One study found that disabled persons used prescription painkillers, sedatives, stimulants, and tranquilizers in higher quantities than non-disabled persons. The following forms of past month drug abuse were higher:
- crack cocaine
Overall substance abuse was higher in disabled persons versus non-disabled, with 40 percent and 34 percent, respectively.
What Is Considered A Disability?
A disability occurs when a person’s body or mind is impaired in such a way that they are unable to engage in one or more major activities within their life.
There are three factors which influence a person’s ability to function in these ways, including:
- Impairments: A person’s physical or mental states don’t function properly. Examples include hearing or memory loss.
- Activity limitations: A person is unable to do certain tasks because of these things. For example, they may have trouble hearing or solving problems.
- Participation restrictions: A person isn’t able to participate fully, if at all, in daily life activities because of these limits. This may impact the way they engage in work, social, recreational, or health-related activities which are important to their health and well-being.
A disability may occur because of a condition a person is born with, or it may happen because of an injury or disease. Disabilities may progressively worsen over time, remain unchanged, or come and go. Not every disability may be apparent to the casual observer, however, this does not mean that a person does not struggle.
A disability may affect a person’s:
- ability to communicate
- ability to learn
- mental health
- social relationships
- thinking (cognition)
Disabilities affect a wide variety of people from all walks of life. The effects of these conditions vary person to person, and one person may be affected by their disability in a way different from another person with the same condition.
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A condition may be referred to as physical or mental (cognitive) disability, however each of these categories contains numerous disabilities that affect a person’s mind and body in different ways. Disabilities are broken down into more specific categories including:
- developmental disabilities
- intellectual disabilities
- learning disabilities
- physical disabilities
- sensory disabilities
Some conditions may be referred to as more than one type of disability. For instance, autism spectrum disorder may be classified as a developmental or sensory disability, in addition to being considered a mental disorder.
Not every person with the following conditions considers themselves disabled, however, this does not mean that the symptoms aren’t at times disabling, or that they might not be considered disabled in the future.
Understanding Physical Disabilities
A physical disability may be caused by an accident, age, birth defects, or a disease. These conditions may make it difficult for a person to take part in social activities. A person’s mobility and movement may be impaired by these disabilities, making it hard to work around certain physical barriers within the home, job, or at school.
Physical disabilities also include chronic health conditions which disable a person from engaging fully in their day-to-day life. This includes a variety of autoimmune diseases.
Examples of physical disabilities include:
- allergies (food/environmental)
- cerebral palsy (CP)
- Crohn’s disease
- cystic fibrosis
- irritable bowel syndrome (IBS)
- loss of a limb
- migraine headaches
- multiple sclerosis
- rheumatoid arthritis
- sickle cell anemia
- spina bifida
- spinal cord injuries
- traumatic brain injury
- ulcerative colitis
Certain diseases may cause a symptom which becomes a secondary disability. An example is diabetes. Diabetes may cause loss of a limb, nerve damage, or vision loss, each of which may be a disability.
Understanding Developmental Disabilities
Developmental disabilities impair a person on a behavioral and physical level. They may also affect an individual’s ability to learn or use language. These disabilities most typically begin prior to birth, however individuals may develop one after this time due to an injury or infection.
Developmental disabilities include:
- attention deficit hyperactivity disorder (ADHD)
- autism spectrum disorder
- cerebral palsy
- hearing loss
- intellectual disability
- learning disability
- vision impairment
Recent estimates in the United States show that about one in six, or about 15%, of children aged 3 through 17 years have a one or more developmental disabilities. In many cases these disorders may last for a person’s whole life. -CDC
Understanding Intellectual Disabilities
An intellectual disability may occur before birth or up to age 18. It may be caused by a disease, injury, or issue within the brain. One percent of the population is affected by an intellectual disability.
Intellectual disabilities may be minor to severe. Depending on the severity of the disability, a person may have a hard time taking care of their basic needs, expressing emotions, speaking, or even walking. Intellectual functioning is reduced and marked by a lower IQ.
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A person may also struggle on a social and interpersonal level, to the extent they struggle to form relationships or engage in important responsibilities which enhance their life. An individual with this disability may not be able to live on their own and require assistance or supportive housing.
Understanding Learning Disabilities
Learning disabilities change the way a person is able to listen, calculate mathematics, read, speak, spell, and/or think. A disability of this sort may impede a person’s ability to take in, process, recall, or express information. It could even affect their fine or gross motor skills.
Because of this, a person may struggle to communicate, suffer from memory problems, have poor executive functioning, or have a hard time performing job- or school-related tasks.
- auditory processing disorder (APD)
- language processing disorder
- nonverbal learning disabilities
- visual perceptual/visual motor deficit
Though not considered learning disorders, ADHD and dyspraxia often accompany and make certain learning disorders more complex.
Understanding Sensory Disabilities
Sensory disabilities impair one or more of a person’s five senses (hearing, sight, smell, touch, and taste). When a person struggles to obtain information from one of these senses, the way they process the world around them may be changed.
A person with a sensory disability may have:
- autism spectrum disorder (ASD)
- blindness or vision impairment
- deafness or being hard of hearing
- sensory processing disorder
Understanding Mental Disorders And Mental Illnesses As Disabilities
A variety of mental disorders and mental illnesses may impair a person’s ability to function within their life to the extent they become disabled. Examples include:
- Alzheimer’s disease or other forms of dementia
- autism spectrum disorder
- bipolar disorder
- delusional disorder
- eating disorders (anorexia nervosa, bulimia nervosa, and binge-eating disorder)
- impulse-control disorders
- intermittent explosive disorder
- neurocognitive disorders
- obsessive-compulsive disorders
- personality disorders (antisocial personality disorder, borderline personality disorder, etc.)
- post-traumatic stress disorder (PTSD)
- somatic symptom disorder
- Tourette syndrome
How Are Disabilities Linked To Substance Abuse And Addiction?
Many disabled individuals have received little to no education on the prevention of a substance use disorder. This leaves them ill-equipped to handle peer pressure, temptation, and concerns of self-medication.
A person with a disability may desire social acceptance and use drugs or alcohol as a means to connect to their peers or to have what they perceive as a social life. Others use these substances as a means to escape loneliness or isolation brought upon by their disability.
Many disabled individuals with a substance use disorder begin using drugs or alcohol as a way to cope their disability and any physical or mental side effects which accompany it. Self-medication occurs heavily in individuals with pain concerns and mental health disorders.
Substance Abuse Risk Factors For Disabled Individuals
A risk factor places a person at an increased risk for addiction. Risk factors stem from a variety of life experiences and personal factors, including a person’s family life, community, health, and genetic factors.
Chronic health condition, such as many physical disabilities, are in themselves risk factors. Similarly, mental health conditions are also common risk factors for substance use disorders.
Individuals with a disability may face the following risk factors for a substance use disorder:
- being enabled by loved ones or caregivers
- chronic or recurring pain
- prescriptions for pain medications
- chronic or recurring health or medical problems
- depression or anxiety
- impaired cognition
- isolation and loneliness
- academic problems
- limited education
- lower socioeconomic status
- poor self-esteem
- current or past physical or sexual abuse
- neglect or abandonment
While the presence of a risk factor does not mean a person is guaranteed to develop an SUD, it does mean that there is a higher likelihood that they could. For a person with a physical or mental disability, this road may be more perilous than most.
Substance Abuse Can Decrease A Disabled Person’s Quality Of Life
A declining quality of life is a hallmark sign of addiction. Prolonged and chronic substance abuse can deteriorate anyone’s quality of life, but for a disabled individual these effects may be felt more heavily.
An active substance use disorder can damage a disabled person’s life and health by:
- impairing their ability to think (cognition)
- making it difficult for them to maintain coordination and muscle control
- causing an interaction with certain medications (such as those which are prescribed for the disability or accompanying health conditions)
- making it difficult for them to practice essential patterns of self-care
- making difficult for them to communicate effectively about their needs and health
- creating isolation
- creating instability at home
- making it difficult for a person to progress through their schooling
- negatively impacting a person’s career or vocation, causing underemployment or the loss of a job
Each of these changes may make it more difficult for an individual to manage their disability and stay healthy. As a person’s health deteriorates the disability may worsen or a secondary, disabling condition may develop. As a person struggles to cope with these things they may continue using drugs or alcohol, which could lead to or worsen an existing addiction.
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Is Addiction A Disability?
According to the American with Disabilities act, a drug addiction may be considered a disability if it significantly limits one or more major life activities. A person cannot currently be using illegal drugs at this time. Alcoholism is also considered a disability by the ADA.
Can Substance Abuse Cause A Disability?
Substance abuse has caused disabilities in some individuals:
Consuming drugs or alcohol while pregnant has been linked to the development of certain disabilities. One example are fetal alcohol spectrum disorders (FASDs), which may cause physical or intellectual disabilities.
Substance abuse may cause or worsen a mental health disorder like anxiety or depression.
“Substance misuse/abuse is also a major contributing factor to many traumatic injuries…alcohol intoxication rates at the time of traumatic brain injury range from 36% to 51%, ” according to The Disability and Health Journal.
Co-Occurring Disorders Among The Disabled
Our mental health is shaped by our thoughts, emotions, and behaviors. Disabled individuals have higher rates of stress and depression versus non-disabled individuals. Stress is a major risk factor for addiction, as is depression.
World Psychiatry cautions that “Adults with severe mental illness have extraordinarily high rates of co-occurring substance use disorders, typically around 50% or more.”
Individuals with a co-occurring mental health disorder are best treated with individualized, dual diagnosis care. The best treatment outcomes occur when the SUD, mental illness, and disability are treated within the same program.
Barriers To Treatment
Many individuals in need of treatment face barriers which prevent them from seeking or obtaining treatment. This is true for disabled and non-disabled individuals alike. Frequently reported barriers include financial hardships, lack of insurance, family obligations, and health or medical conditions.
Individuals with a disability, however, face additional barriers which can delay treatment. Many disabilities may isolate a person, which limits the opportunity that the substance use disorder be spotted.
Once a person decides they want treatment, many disabled individuals may not be able to drive themselves to treatment. Disabilities prevent many individuals from working, which may limit the financial resources a person can commit to treatment.
It can be difficult to find a treatment program which is accessible and meets the needs of a disabled individual. Many treatment centers have physical barriers which make it hard for a person to navigate their surroundings or to reach certain locations within the facility. Others do not have accommodations in place for those with sensory disabilities like blindness, sight problems, deafness, or hearing difficulties.
Once in treatment, treatment clinicians may not have the proper training to administer the needed treatments to a disabled person. Without the proper training, treatment staff may think that a person isn’t motivated to obtain sobriety.
Certain disabilities may make it hard for a person to process and retain information. This may limit their ability to engage in treatment and make it appear as if they’re not committed to treatment. This could cause poor morale and cut a person off from the support and teaching they need during treatment to heal and build sobriety.
Finding Substance Abuse Treatment For Persons With Disabilities
The most effective treatment programs are tailored to a person’s unique health and medical needs, including those which surround their disability. Inpatient drug rehabilitation programs offer greater stability, peer support, and access to counseling and therapy, components which may greatly benefit a disabled person.
Disabled individuals may require access to medical, social, or legal services. They may also benefit from vocational rehabilitation and enhanced life skills training. This combination of services can help a person learn how to better manage their disability within a newly sober life.
Certain addictions may require a medically-assisted detoxification prior to beginning treatment. During this time certain medications will be used as part of medication-assisted therapy to safely treat symptoms of withdrawal.
Many disabled individuals may benefit from a step down, outpatient program which helps them adjust to the demands of sober living. Sober, supportive living homes may help individuals who need assistance with the demands of day-to-day life.
Aftercare programs are essential within the recovery process, especially for disabled individuals. A good treatment program should offer aftercare support to treatment graduates. These services may offer family therapy, case management, peer mentoring programs, and access to community support programs.