What's the Connection Between Disability and Addiction?

Living with any kind of disability is challenging. But when coupled with a substance use disorder (SUD), it can feel like an impossible battle.

People with disabilities—whether physical, mental, or both—are more likely to experience more severe effects of addiction. They’re also more susceptible to subsequent relapse than the general population. Unfortunately, people with disabilities may also be less likely to receive appropriate treatment for their addiction.

This blog post explores the unique struggles of people with physical or mental disabilities who also deal with addiction. It also discusses appropriate treatment interventions and resources for those facing these challenges.

What’s the Connection Between Disability and Addiction?

The relationship between disabilities and addiction goes both ways. People with disabilities are more likely to develop substance use disorders due to various factors, including:

• Chronic pain or discomfort: People with physical disabilities may experience chronic pain, leading them to resort to drug or alcohol abuse for relief.
• Negative coping mechanisms: People with disabilities may use substances to cope with the daily challenges and emotional toll of living with a disability.
• Barriers to substance abuse treatment: Many people with disabilities face barriers in accessing appropriate treatment for their addiction, including lack of accessible facilities and transportation, financial constraints, and stigma.

Substance abuse can also lead to developing disabilities. This is particularly true for people who use intravenous drugs or substances that harm the body’s organs and systems.

Substance Abuse and Addiction Rates Among the Disabled

Substance abuse is two to four times higher amongst the disabled.⁸ The increased risk is due to the physical or psychological impact of a disability.

Americans from all situations and demographics can develop an addiction. However, addiction is more common among specific disabilities.⁷

• Over 50 percent of people with major spinal cord disabilities abuse substances.

• In the US, one out of every four adults has a disability.
• Alcohol contributes to debilitating illnesses and is a factor in incidents that can result in disabilities, making it the seventh most dangerous risk factor for mortality and disability globally.
• Except for alcohol, people with disabilities (PWD) reported considerably more significant use rates than those without disabilities for each substance evaluated in the National Survey on Drug Use and Health (NSDUH) from 2002 to 2010.
• PWD may self-medicate with substances such as alcohol and marijuana to alleviate pain and psychological distress.

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Disability and Addiction

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What Are the Effects of Addiction Among the Disabled?

Having a disability can decrease the likelihood of current drinking. However, it's associated with an increased probability of prescription drug misuse, any drug use, daily nicotine use, and other drug use.⁷

This can lead to the following:

Physical Impact

Chronic pain plays a significant role in addiction among people with disabilities. It accounts for 17% to 38% of the relationship between disability and various forms of substance use. This includes prescription drug misuse, other drugs, and nicotine.

Medications like Oxycodone, Morphine, and Fentanyl are highly effective at relieving pain. However, these drugs also come with a significant risk of addiction.

The convenience of administering opioids through an IV or a controlled button press makes them easily accessible. This increases their potential to lead to abuse and addiction.

Impact of Drug Use on Those with Physical Disabilities

People with disabilities may rely on opioids to manage chronic pain due to their condition. For instance, amputees often receive opioid infusions following surgery to alleviate pain.

Drug use can have more severe side effects on people with physical disabilities due to the heightened chance of complications. These include:

• Worsening of symptoms or conditions
• Negative interactions with medications and treatments
• Increased risk for accidents and injuries

Opioids can cause dizziness and impaired coordination, significantly increasing the risk of falls and injuries, which can be particularly dangerous for individuals with physical disabilities.

Psychological Impact

There's a psychological toll that comes with having a disability, affecting daily life and relationships. Many people with disabilities face the following problems:

• Increased risk of mental illness
• Chronic medical problems and pain
• Easier access to prescription medications
• Social isolation
• Lack of access to education
• Risk of unemployment and poverty
• Increased risk of physical and sexual abuse
• Enabling by caregivers

These become risks for addiction. Many people turn to substances to cope with mental health issues.

Social Perception and the Emotional Strain of Disabilities

It's human nature to want to fit in. But a visible disability can place extra pressure, making you feel different and uncomfortable in public settings.

Mental disorders may also cause discomfort or anxiety when interacting with others. This is where drug use leads to a false sense of comfort in addiction, which can worsen mental and emotional disabilities. It’s a cycle that’s damaging physically and mentally.

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Addiction Treatment Options

Comprehensive treatment is vital for anyone suffering from addiction. Treatment includes:

• Rehabilitation: A specialized program that focuses on breaking the cycle of addiction.
• Therapy: This may include individual or group counseling, cognitive behavioral therapy, and other forms of therapy to address underlying issues.
• Medication-assisted treatment (MAT): This type of treatment combines medication with therapy to help manage withdrawal symptoms and cravings.
• Support groups: These can provide community and accountability during recovery.

• Aftercare programs: Continuing care after treatment can help prevent relapse and provide ongoing support.
• Physical therapy: For those with physical disabilities, incorporating physical therapy into their treatment plan can help improve mobility and overall health.
• Additional resources: This may include access to online support groups, emergency hotlines, and educational materials.

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Who are Considered Disabled People?

According to the Americans with Disabilities Act (ADA), a person with a disability is someone with a physical or mental impairment substantially limiting one or more major life activities.⁶ This can include mobility, seeing, hearing, breathing, learning, and communicating.

A person with a history of these impairments or those currently dealing with one may also be considered disabled under the ADA. This broad definition can encompass various conditions, from chronic physical illnesses to mental health disorders.

Challenges and Nature of Disabilities

People can have short-term, long-term, or permanent disabilities. These people may face the following difficulties:

• Physical
• Mental
• Emotional

People with disabilities can be inherently born with them. Others may have them due to suffering from injury or misusing substances. In either case, life can be particularly challenging when coupled with addiction.

Is Addiction a Disability?

On its own, drug or alcohol addiction may not qualify as a disability. However, if the condition affects major life activities such as working, caring for oneself, or socializing, it could be considered a disability.

Addiction can sometimes lead to physical disabilities due to health complications or accidents. This makes it crucial to seek help and support when struggling with addiction. Moreover, addiction is a treatable condition, and seeking treatment can improve your quality of life.

Substance Use Disorder and the ADA

The Americans with Disabilities Act (ADA) covers disabilities significantly impacting major life activities. This includes physical, mental, emotional, and psychological impairments.

Substance use disorder (SUD) falls under the category of a disability if it substantially limits one or more major life activities. If you have an SUD but can still perform daily tasks without significant impairment, it may not be considered a disability under the ADA.

If your addiction is severe enough to affect major life activities, you're protected under the ADA. Reasonable accommodations under the ADA include providing time off for treatment, modifying job duties to support recovery, or ensuring a safe and supportive work environment.

The SSA's Criteria for Disability Due to Substance Abuse

The Social Security Administration (SSA) evaluates disability status based on the severity of the condition and its impact on an individual's ability to work and perform daily activities. The SUD can sometimes lead to disability, particularly when it results in irreversible damage or substantially limits one's capacity to engage in gainful employment.

In many cases, people who receive treatment can return to normal function. In instances where abstinence won't reverse their disability, they will receive financial support.

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Summary

Drug and alcohol addiction can have a more significant impact on people with disabilities. The heightened risk of complications, combined with the psychological and social impacts of their disability, can make them more vulnerable to substance abuse.

Addiction among people with disabilities can result from injuries, genetic conditions, or a predisposition to substance use. This results in a cycle of developing dependence on substances to cope with their conditions.

It's important to understand the criteria for disability under the ADA and SSA and the various treatment options available. By addressing both the physical and psychological aspects of addiction, people with disabilities can overcome their struggles and live healthier lives. Consult your healthcare provider to receive the proper help you need.

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