Understanding the Risk: Substance Use Disorder Among People with Disabilities

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Substance abuse is known to compromise work performance, resulting in high rates of absenteeism, accidents, time off for illness, and worker's compensation claims.

Unfortunately, people with disabilities are at a much higher risk for substance use disorders compared to their peers without disabilities. In all, approximately 4.7 million people have a co-occurring disability and substance abuse problem.

A substance use disorders occurs when the recurrent use of alcohol and/or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home. SAMHSA

The symptoms and limitations of substance use disorder can add to the already complex challenges faced by many people disabilities. Early identification of co-occurring substance-related disorders among people with disabilities may minimize the secondary complications they produce, decrease rehabilitation costs, and improve overall outcomes.

To better serve people with disabilities who may have a co-occurring substance use disorder, become familiar with foundational information on this complex topic:

  • Why people with disabilities may abuse substances
  • Which disability populations may be most vulnerable
  • How to identify the symptoms of substance abuse
  • Awareness of assessment and treatment options

Why People with Disabilities May Abuse Substances

Studies indicate that substance use disorders and other drug-related harms are more likely to occur when a person has experienced risk factors such as a family history of substance use disorders, personal trauma, or access to drugs (National Institute on Drug Abuse (NIDA).  NIDA has classified four main reasons why people in general may use drugs:

  • To feel good. People may desire the feeling of pleasure, which is when they experience high or intoxication. People use substances to feel euphoria, calm, and increased perception and sense.
  • To feel better. They use substances as a stress reliever, to avoid or forget problems, or to feel numb.
  • To do better. They may use substances to seek improvement in their performance and cognition.
  • Curiosity or peer pressure. They may use substances out of curiosity, or they want to experiment, or they might feel pressure from their peers to try substances.

People with disabilities are no different from people in the general population in their desire to feel good, do better, and fit in with their peers. But they face additional barriers to a high quality of life, such as:

  • Complex challenges of living with a disability and receiving appropriate, related services
  • Pain and other medical issues that may lead to misuse of prescription medication and/or self-medication with nonprescription substances
  • Lack of timely identification of potential problems
  • Lack of accessible and appropriate prevention and treatment services

Disability Populations Most Vulnerable to Substance Abuse

The three types of disabilities that have the highest prevalence rate of coexisting substance abuse are:

  • Mental illness - Approximately 40% of all individuals with mental health conditions have a coexisting substance use disorder.
  • Brain injury and spinal cord injury - People with traumatic brain injury and spinal cord injury in the United States approaches or exceeds 50%.
  • Deafness, arthritis, and multiple sclerosis - Individuals with these disability types have a risk for substance use disorders that is at least double the rate of the general population.

Symptoms of Substance Use Disorder

Warning signs of substance use disorder include:

  • Changes in personality and behaviors
    • Being secretive or drastic changes in behavior and relationships
  • Physical health issues
    • Lack of energy and motivation, weight loss or gain, or red eyes
  • Neglected appearance
    • Lack of interest in grooming or looks
  • Problems at school or work
    • Frequently missing, sudden disinterest, drops in performance
  • Financial issues
    • Sudden requests for money without reasonable explanation, money being stolen, and/or items disappearing from home

Awareness of Assessment and Treatment Options

Vocational rehabilitation professionals may not always be able to conduct thorough assessments or be qualified to provide treatment of substance use disorders. However, being aware of the warning signs and symptoms of substance abuse, and being knowledgeable of appropriate assessment and treatments could provide clients with the support they need to seek and receive appropriate treatment.

For a thorough discussion of assessment and treatment options, we encourage you to watch TACQE U’s Substance Use Disorder 101: A Conversation on the Basics.

Sources: Information in this article was taken from TACQE’s Substance Use Disorder 101: A Conversation on the Basics and  Substance Related Disorders 101 webinars.

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