Substance Abuse Amongst The Disabled Population

The already terrible burdens that illegal drugs, alcohol and tobacco issues present are compounded when the person involved is a member of America’s largest minority, People with Disabilities, who may experience mental or physical forms of disabilities.

disabilitieFor people who experience forms of disabilities, the process of recovering from addiction is complicated by barriers that simply do not exist for others. Attempts to recover from an addiction to a substance can be greatly hindered by issues associated with physical or mental disabilities.

Estimates have indicated that addiction issues cost the economy of the United States more than $220 billion dollars each year and directly impact a large percentage of the population of this nation. The thing that is less understood is that people in the United States who experience forms of disabilities are at a disproportionately greater risk for experiencing these issues. People with disabilities experience many risks that increase their chances for substance abuse negatively affecting their lives. The risks include:

Societal enabling
Health and medication issues
A lack of identification of possible issues
A lack of appropriate and accessible prevention and treatment services

In some instances, the prevalence rates for substance abuse among people with disabilities is shocking. Substance abuse prevalence rates approach or exceed 50% for people who experience spinal cord injuries, traumatic brain injuries, or forms of mental illness. When compared to the 10% rate for the general population, the statistic is stunning.

The statistics present further stunning revelations unfortunately. People with orthopedic disabilities, spinal cord injuries, amputations, or vision impairment may be classified as, ‘heavy drinkers,’ in around 40-50% of cases. People with disabilities experience substance abuse rates that are 2-4 times that of people in the general population. People with forms of disabilities to include arthritis, deafness, or multiple sclerosis experience substance abuse rates that are at least double the rate for those in the general population. Sadly, the major causes of disabilities in the United States are changing from medical to social and behaviorally-related conditions and are increasingly involving complications that include violence, substance abuse, and poor mental health.

Serious Mental Illness and Substance Abuse

The reason substance abuse and people with disabilities is such a serious issue is because People with Disabilities are the 33.2 Million Adults with Serious Mental Illness (SMI)largest minority population in the United States of America. There are more than 54 million people in the United States who experience a form of disability. Many of us are very plainly not being cared for and are unhappy.

It is commonly accepted that around 10% of the general population in this nation experiences alcoholism while another 5% experiences an addiction to drugs. People who experience traumatic head injuries or spinal cord injuries are known to also experience substantially higher rates of substance abuse issues than people who experience intellectual disabilities, however. Despite this fact, people with disabilities as a whole have many more risk factors than people in the general population in the United States.

The year 2002 found 33.2 million adults in the United States experiencing a form of Serious Mental Illness (SMI). Out of this population of people, 13.4 million or 40.4% experienced only their form of SMI, while 15.7 million or 47.4% experienced only a substance abuse disorder. From this population of people 4 million or 12.2% experienced both an SMI and a substance abuse disorder. A cautious estimate of the number of adults with a substance abuse disorder and a form of disability is around 4.7 million people in the United States.

People with Intellectual Disabilities and Substance Abuse

The integration of people with forms of intellectual disabilities into their communities as the United States evolved socially found them being exposed to substances such as drugs and alcohol as well. Adults with intellectual disabilities are usually less likely to use drugs or alcohol as a population than adults without intellectual disabilities. They tend to live with family members, friends, or caregivers who provide them with a certain level of monitoring and because of this they receive the opportunities to engage in adult choices, yet find themselves limited by the presence of those who provide care for them.

Intellectual Disabilities and Substance AbuseDespite the presence of caregivers, opportunities to abuse drugs or alcohol still exist. Some people with intellectual disabilities do not use drugs or alcohol, while those who do are more likely to develop an abuse issue. A study performed in the year 2010 reviewed Medicaid health care billing claims and came to the conclusion that 2.6% of all people who experience a form of intellectual disability had a diagnosable substance abuse disorder. Other estimates using different methodologies present statistics suggesting rates of drug and alcohol abuse among people with intellectual disabilities as high as 26%.

When a person who experiences a form of intellectual disability also has a form of mental illness – referred to as a, ‘dual diagnosis,’ the estimates of co-occurring substance abuse range from 7% to as high as 20%. The numbers are shocking, particularly when compared to substance abuse among people without forms of intellectual disabilities who experience a form of mental illness where rates are estimated to be 7.6%. The notion that people with intellectual disabilities do not use drugs or alcohol is clearly a myth.

People with intellectual disabilities who are also substance abusers have some unique traits in common. As a group they tend to start drinking alcohol a couple of years later than people without intellectual disabilities; they are also less likely to be Caucasian. Members of this group are unfortunately less likely to pursue help for substance abuse and even if they do seek help, the resources that are helpful for people in the general population often times do not accommodate their needs. In addition, members of this group are at high risk of complications from drinking because they tend to be prescribed medications for other conditions such as metabolic disorders, seizures, or co-occurring forms of mental illness that have the potential to negatively interact with drugs and alcohol.

The Treatment Dilemma

Treating people with disabilities who experience drug and alcohol abuse issues involves a number of things. None of the things involved with treatment are inexpensive or easily accomplished. Among the things involved in treatment are:

Health care costs
Chemical Dependency treatment

There are millions of students in special education programs in the United States. Unfortunately, there are very few substance abuse prevention programs in place that address this population of students and their learning needs.

An estimated 68% of adults with disabilities are not involved in the workforce, despite the fact that the majority of them would like to participate. Substance abuse has a significant role in this statistic. One estimate suggests that around 25% of people with disabilities who participate in vocational rehabilitation programs also experience a significant secondary issue with substance abuse.

Health care and hospital costs are exceptionally high for people with disabilities. Alcoholics who remain untreated, on average, incur general health care costs that are at least double those of non-alcoholics. The disparity may continue for more than a decade before they enter into a treatment program. The costs and rates of alcohol-related hospitalizations among people with disabilities are much higher than they are for people in the general population in the United States.

People who experience forms of hidden disabilities, such as mental illnesses, learning disabilities, or attention deficit disorder are a substantial sub-population of people with disabilities. The disabilities they experience have been linked to increased rates of substance abuse. Sensitivity to disabilities within the chemical dependency treatment community would increase the effectiveness of treatment and better address the needs of those who are currently clients.

A number of reasons exist in regards to why this is such a dilemma. For example, substance abuse prevention, intervention and treatment services are not attitudinally, physically, financially, or cognitively accessible to people with disabilities for a variety of reasons. Many people with disabilities struggle with recurring substance abuse issues and become frustrated with efforts associated with rehabilitation, employment, and integration into society. The economic costs related to drug and alcohol abuse and people with disabilities are huge when taking into account governmental obligations in vocational rehabilitation and medical ones, as well as education, social security, job development, and public assistance.

Resources and Citations:

Substance Abuse Resources & Disability Issues

The SARDI Program seeks to improve the quality of life for persons with disabilities, including those who are concurrently affected by behavioral health issues. The SARDI Program achieves its objective by conducting collaborative and participatory research; developing intervention approaches and training; and disseminating related information.

Substance Abuse and the Disabled

While addiction is a very individual disease, people with disabilities often turn to drugs or alcohol as a means of coping with or self-medicating their problems. Conversely, some people who have severe substance abuse issues may develop learning, cognitive, emotional and even physical disabilities as a result of their drug use or simply as an unrelated development. Whatever the case may be, those who suffer from both addiction and one or more disabilities are at a distinct disadvantage.

Improving Substance Abuse Treatment for Persons With Disabilities

Persons with disabilities are at an increasing risk for substance abuse. Recent studies show that people with disabilities may have a number of risk factors, including a lack of ability to identify potential problems with addiction, additional health problems and medication interference, poor access to rehabilitation and treatment programs, and increased societal enabling.
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January 22, 2015


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