Office on Disability - Substance Abuse and Disability

A COMPANION TO CHAPTER 26 OF HEALTHY PEOPLE 2010

OFFICE ON DISABILITY

The Office on Disability (OD) was created by the Secretary of the U.S. Department of Health and Human Services in October 2002. The OD acts as the focal point for programs, policies, and initiatives designed to tear down barriers that prevent the 54 million Americans with disabilities from fully participating in an inclusive community life.

PURPOSE OF THE COMPANION DOCUMENT TO HEALTHY PEOPLE 2010

Eliminating health disparities is a key goal of Healthy People 2010. Persons with disabilities are represented in 207 of the 467 Healthy People 2010 objectives, and data on persons with disabilities are available for only 88 of these 207. Each companion document describes the particular challenges to health promotion and disease prevention affecting persons with disabilities in focus areas addressed in Healthy People 2010. The importance of including persons with disabilities in research is also stressed.

HEALTHY PEOPLE 2010 GOAL

Reduce substance abuse to protect the health, safety, and quality of life for all, especially children.

Alcohol, tobacco, illicit drugs, and prescription medications may all be substances of abuse. Substance abuse and its related problems are among society’s most pervasive health and social concerns. Costs to society include health care expenses, motor vehicle crashes, crime, lost productivity, and death. Each year, about 100,000 deaths in the United States are related to alcohol consumption.

Persons with disabilities are at risk for substance abuse

Risk factors increase the chances for substance abuse to adversely impact an individual’s life. Persons with disabilities often have multiple risk factors. These risks include: medication and health problems, societal enabling, a lack of identification of potential problems, and a lack of accessible and appropriate prevention and treatment services.

How common is substance abuse in the disabled population?

Substance use disorders occur more often in persons with disabilities than in the general population. This includes problems related to the abuse of prescription medications as well as illicit drugs. In the general population, alcoholism affects 10% of individuals and 5% are addicted to drugs.

Moore (2002) estimates that as many as 1.5 million individuals with disabilities may need treatment for substance use disorders in any given year. The Substance Abuse and Mental Health Services Administration (SAMHSA) (2002) estimates that approximately 4.7 million American adults with a disability have a co-occurring substance abuse problem.
Persons with any type of disability experience substance abuse at rates 2 to 4 times that of the general population.
Substance abuse prevalence rates approach or exceed 50% for persons with traumatic brain injuries, spinal cord injuries, or mental illness.
Conditions such as deafness, arthritis, and multiple sclerosis have shown substance abuse rates of at least double the general population estimates.
Where persons with spinal cord injuries, orthopedic disabilities, vision impairment, and amputations consume alcoholic beverages, approximately 40-50% can be classified as heavy drinkers.

Data indicate that rates of substance abuse vary widely across disabilities.

Spinal cord and traumatic brain injury populations have been found to have substantially higher rates of substance abuse disorders than the general population.
Persons with mental retardation tend to have lower rates of substance abuse disorders than the general population.

Many persons with disabilities struggle with recurring substance abuse problems, frustrating efforts at rehabilitation, employment, and successful integration into society.

Substance abuse related services are not accessible

Existing substance abuse prevention, intervention and treatment services are not sufficiently responsive to the needs of persons with disabilities. As a result, access to education, prevention, and treatment services for substance use and abuse can be limited, incomplete, or misdirected.

Health promotion materials, including those about substance abuse, may be written at too high a reading level for a person with an intellectual disability. According to the CDC National Prevention Information Network and the World Bank Organization, the global literacy rate for adults with disability is as low as 3%. For women with disability, the global literacy rate may be as low as 1%.
Materials also might be unavailable in formats accessible to persons with visual impairments (e.g., Braille or interactive technology).
STD educational and prevention literature, videos, presentations, and materials found in print media, on television, and on the World Wide Web primarily show images of persons without disabilities, sending the inaccurate message that persons with disabilities are not at risk.

Treatment centers are often inaccessible to those with physical disabilities.

Transportation issues and sheer distance complicate access to specialized treatment centers for persons with disabilities.
Cultural insensitivity by health care and health promotion providers may prevent persons with disabilities from seeking education, risk-management, and treatment for substance abuse.
Effective communication may be frustrated as a result of limited availability of assistive supports, such as interpreters for persons who are deaf or hard of hearing.
Because health care and health promotion providers alike often focus solely on a person’s disability rather than on the full range of health and wellness needs, they may fail to communicate substance abuse prevention messages that are given routinely to persons without disabilities.

Opportunities

Persons with disabilities need access to substance abuse education and prevention materials that are culturally sensitive, linguistically accessible, and inclusive in order to meet their needs.
There are over 5 million students in special education programs in this county. While substance abuse prevention programs are common in traditional classrooms across the country, there are few matching these students’ learning needs included in special education programs.
Persons with disabilities should be included in research and data statistics.

To Learn More….

The National Association on Alcohol, Drugs and Disability Inc. (NAADD)
http://www.naadd.org/
Voice and TTY: 650-578-8047

Substance Abuse and Mental Health Services Administration (SAMHSA)
http://www.samhsa.gov/index.aspx