Substance Abuse and Disability

Whether a disability stems from an accident or a medical condition, such as multiple sclerosis or a serious mental health disorder, it often has a serious and negative impact on a person’s emotional well-being. Whether a disability stems from an accident or a medical condition, such as multiple sclerosis or a serious mental health disorder, it often has a serious and negative impact on a person’s emotional well-being. In some individuals, that impact leads to the abuse of alcohol or drugs.  Some want to numb the physical and /or emotional pain and sense of loss, while others struggle to distract themselves from having too much time on their hands.

It’s been estimated that over 50 million Americans live with some type of disability. While that statistic includes those born with a mental or physical impairment, it also encompasses those who become disabled at some point during their lifetime.  Individuals with disabilities have a substance abuse rate 2 to 4 times that of the non-disabled population, according to the Department of Health and Human Services. It’s estimated that as many as half of those with an orthopedic disability, spinal cord injury, amputation, or vision impairment can be classified as heavy drinkers. Additionally, arthritis sufferers and those with multiple sclerosis have high rates of drug and alcohol abuse – nearly double the rate of the general population.

Potential Reasons for Higher Risk

Following are several potential reasons that living with a disability can increase the risk for substance abuse and addiction:

Substance Abuse and DisabilityThe disability comes from a head injury or affects cognitive ability. Individuals who have experienced a reduction in their ability to think clearly don’t always recognize that abusing substances is dangerous.  They also may not be able to recognize the problem if they already have one. Furthermore, some individuals with traumatic brain injury, in particular, believe the use of alcohol will improve their ability to interact socially.

The disability is a mental health disorder. Disability is a word often connected to physical impairment, but psychiatric conditions can also seriously hamper a person’s ability to function. Major depression, post-traumatic stress disorder, schizophrenia, and bipolar disorder are just a few of the mental health conditions that make it difficult for a person to live a “normal” life. As a result, the person is more vulnerable to using substances in a desperate attempt to alleviate troubling symptoms, such as insomnia or low energy, and numb painful emotions.

The disabled person’s loved ones act as enablers. Sometimes family and friends unintentionally enable substance abusers. For instance, a spouse who feels badly about a partner’s serious injury may be reluctant to say “no” when asked to run to the liquor store for a bottle of tequila. Other loved ones simply ignore the use of alcohol or drugs, telling themselves that the person has had a hard enough time living with the disability – why shouldn’t he or she be able to enjoy smoking a few joints or drinking a few beers?

Substances can be used to self-medicate emotions or symptoms. The challenges of living with a disability are, at times, overwhelming. Some disabled individuals turn to alcohol or drug use in the belief it will relieve the pain of negative emotions, such as anger, frustration, sadness, or guilt. Furthermore, many substances numb physical symptoms as well. In one study approximately 25% of patients with chronic jaw or facial pain or arthritis had used alcohol in an attempt to relieve the pain. While this study didn’t specifically examine those disabled by chronic pain, it does suggest that self-medication is widespread enough to be a concern.

A person with a disability may not have access to proper treatment. Physical disabilities and mental health conditions, such as impaired visions or severe depression, leave some individuals essentially trapped in their homes. The logistics of living with the disability prevent them from receiving regular medical care that would otherwise provide education or screening for substance abuse, followed by the necessary treatment.

Some experience a lack of social support. Many individuals who become disabled end up losing much, if not all, of the social support they had prior to their disability. Their condition and, perhaps, the stigma attached to it, keep friends and family away. This social isolation potentially leads to the loss of other sources of support as well, including that from former co-workers, neighbors, and even fellow church members. The loss of much-needed emotional support and sense of connection can make them very vulnerable to abusing alcohol or drugs.

Dangers of Untreated Substance Abuse in the Disabled

Whenever substance abuse and addiction go untreated, there are inevitable consequences – especially as time goes by.  For example:

Drug and alcohol abuse hampers proper medical care. Many disabling conditions require ongoing treatment. Individuals who are abusing substances are less likely to comply with medical advice regarding their disability. For instance, they may miss physical therapy appointments or neglect to take medication that requires adherence to a strict schedule.  Unfortunately, not adhering to treatment can make their condition worse, creating even more problems for them.

Many substances interfere with prescription medications. Another danger involves the way substances, especially alcohol, interact with certain medications. For example, the combination of alcohol and certain antidepressants can impair a person’s alertness and ability to think clearly. Mixing opioid pain medications with alcohol is also extremely dangerous.  When painkillers like oxycodone, hydrocodone and codeine interact with alcohol, their sedating effect is intensified.  This can cause respiration to become dangerously slow.  Alcohol has been implicated in many overdoses involving opioid pain medications.

Drug or alcohol abuse worsens some conditions. For instance, a person with a spinal cord injury is already more vulnerable to chronic bladder infections. Alcohol use further irritates and inflames the bladder, as well as interferes with certain medications used to treat infections. Likewise, many substances impair coordination, making relatively normal movement even more difficult – if not impossible – in someone already hampered by mobility challenges [2].

Substance abuse itself creates additional problems. Living with a disability on its own is challenging. For example, depending on the severity of the condition, a person could have trouble finding work or staying employed. Alcohol and drug abuse compound the problem by further limiting physical and cognitive abilities. Getting drunk or high often results in tardiness, absenteeism, and reduced productivity, any of which can lead to termination.

Substance Abuse Treatment

Because of the dangers of drug and alcohol abuse in those with disabilities, treatment is critical. Consult an addictions professional skilled at working with individuals who live with disabilities. He or she will develop a treatment plan, which will likely include outpatient or residential substance abuse and / or addiction treatment. It’s also important for the recovery plan to take the disabled addict’s physical needs into consideration. For example, a person utilizing a wheelchair may need special transportation to and from Alcoholics Anonymous meetings.

Living with a disability has a serious impact on a person’s well-being, but the addition of alcohol or drug abuse further reduces quality of life. If you have concerns about substance abuse in yourself or a loved one, contact a drug and alcohol treatment center today.  The sooner you get the help you need, the sooner you can get on the road to recovery.

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