Disability And Addiction

The Link Between Disability And Substance Use

People with disabilities, whether they be physical, mental, or intellectual, have an increased rate of developing co-occurring substance use disorders. Studies show that adults with a disability have approximately a 2-3 times increased risk of developing an addiction to drugs and alcohol.

The inverse can also be true. People with an addiction are also more likely to become disabled, either through accidental injury or through long-term side effects of substance abuse. For example, alcohol is known to be a major culprit in automobile accidents, traumatic brain injuries, and mental health conditions such as depression and anxiety. Similarly, an opioid overdose can result in an anoxic brain injury, requiring a person to receive around-the-clock care for the rest of their lifetime.

Challenges For Those With Disabilities And Addiction

People with disabilities face unique challenges and causes connected to substance misuse, including mental health struggles, social isolation, unemployment, and population-specific barriers to treatment.

Co-occurring disorders, like depression, anxiety, and unhealed trauma, are especially common among disabled Americans. As a result, many people with disabilities may turn to drugs or alcohol to cope with loneliness and mental health struggles.

Additionally, individuals with mental and physical disabilities battle unique and adverse stressors, such as:

• Chronic pain
• Unemployment
• An increased risk for health conditions like obesity
• An increased risk of being a victim of a violent crime
• Social perspectives that see them as outsiders
• An inability to qualify for certain careers
• Lack of access to certain benefits
• An inability to participate in several activities to the extent that they would like

All of these factors contribute to the higher rates of substance use seen in the disabled community.

Unfortunately, people with disabilities who also have an addiction are also less likely to receive treatment for their substance use disorder due to the stigma and stereotypes that surround disabilities and addiction. Additionally, the lack of Americans with Disability Act (ADA) accessible treatment and rehab facilities and tailored treatment programs for people with disabilities are major barriers to treatment for the disabled community.

Types Of Disabilities

Disabilities are impairments of the mind or body that prevent or make it more difficult for a person to do a particular activity and interact with the world around them. They can occur at birth or at any time throughout life and are categorized into physical, mental, and intellectual types. A disability can be either short-term or long-term, and in many cases, lifelong.

Physical Disabilities And Addiction

Physical disabilities limit movement, physical activity, stamina, and dexterity, and can include:

• Spinal cord injuries
• Amputations
• Chronic medical conditions such as multiple sclerosis or arthritis
• Blindness
• Deafness
• Congenital disabilities such as cerebral palsy

One of the most common links between physical disabilities and addiction is chronic pain. Chronic pain from a physical disability can profoundly affect a person’s sleep, mood, quality of life, and function, even when on an appropriate pain medication management plan with a pain specialist.

Individuals with a physical disability who have chronic pain and take prescription pain opioid medications are at an increased risk of developing an addiction because of the addictive nature of opioids. This can increase the risk of developing a tolerance and needing more opioids over time, and then turning to illicit opioids such as heroin.

Additionally, people with physical disabilities suffering from pain may turn to alcohol or illicit drugs to help ease their pain, especially if they do not have medical insurance or access to prescription pain medications.

Mental Disabilities And Addiction

Mental disabilities are categorized as mental health disorders and include diagnoses such as:

• Depression
• Anxiety
• Schizophrenia
• Bipolar disorder
• PTSD

Studies show that 50% of people with mental health disorders will develop an addiction. This is because addiction and mental health disorders share many of the same risk factors, including past trauma, genetic disposition, chronic stress, and defects in the dopamine reward brain circuits.

An individual struggling with a mental disability, such as schizophrenia, may use drugs or alcohol to cope with their symptoms, which can increase their risk of developing an addiction.

The inverse is also true; a person with an addiction to alcohol or drugs is more at risk of developing a mental disability, such as depression, because their addiction has hijacked and recircuited their brain’s reward system. When this happens, once-pleasurable activities, such as playing sports or listening to music, no longer trigger enough dopamine to produce a sense of happiness and euphoria, so the person becomes emotionally blunted.

Intellectual Disabilities And Addiction

Intellectual disabilities are characterized by significant limitations in intellectual functioning, such as learning, problem-solving, social judgment, following rules, and abstract and critical thinking. Examples include:

• Autism
• Down Syndrome
• Fetal alcohol syndrome
• Traumatic brain injuries

Intellectual disabilities are often present at birth but may not be diagnosed until later in childhood because they present with a spectrum of symptoms. Studies show that 5% of people with intellectual disabilities also have a co-occurring addiction; however, these numbers may be skewed because symptoms of intellectual disabilities often mask substance use disorders, making addiction more challenging to recognize in this vulnerable population.

People with an intellectual disability who also have a co-occurring addiction may face more severe consequences when they use drugs and alcohol compared to the non-disabled population. These include:

• Increased social isolation
• Poor impulse control
• Decline in cognitive function
• Victimization while under the influence
• Problems with the criminal justice system

This population is at increased risk of addiction because they are more vulnerable. They may be victims of bullying, and as a result, peer pressure and the desire to fit in may drive them to use drugs and alcohol.

They may use substances to cope with feelings of loneliness and depression. Unfortunately, these individuals are more at risk of being victims of abuse, such as sexual and physical abuse, as well as neglect, and they may turn to alcohol and drugs to cope with the trauma associated with the abuse.

Is Having An Addiction Considered A Disability?

According to the ADA, addiction is considered a disability, and people with a substance use disorder can be protected under the ADA with certain limitations.

Addiction is considered a disability because, by definition, addiction negatively impacts the person’s ability to function on multiple levels throughout their daily life. Addiction affects the brain, resulting in altered brain chemistry and neural pathways that can cause changes in behavior and function, and because of this, addiction is considered a chronic disease.

Untreated addiction can further damage the brain and result in long-term medical conditions affecting nearly every organ in the body. Overdose, traumatic accidents, and poor decision-making are also consequences associated with addiction, and therefore, labeling addiction as a disability under the ADA encourages people to seek help before their addiction destroys lives.

Under the ADA, people with a current addiction who are in recovery or who have gone through recovery in the past are protected from discrimination by their employers. They are entitled to employer accommodations such as leave for rehab and flexible treatment schedules. However, employers have a right to test for illegal drugs. It is important to note that the ADA protects addiction as a disability, but it does not protect current, illegal drug use.

Is Addiction Treated Differently Than Other Disabilities?

The Social Security Administration (SSA) and the ADA do not treat addiction differently from other disabilities; however, this may not hold true among the general population, as well as many healthcare professionals. Unfortunately, people with addiction face intense negative stereotypes, discrimination, and stigma, which can impact their mental health and recovery. Because of the stigma surrounding addiction, much of society treats addiction differently compared to other disabilities.

Although first-time drug or alcohol use may have been a choice, addiction is a brain disease that can impact how a person thinks and behaves. Addiction is not a moral failing. Unfortunately, there is a lot of disinformation around addiction, which contributes to the negative stigma, stopping a lot of people from seeking help. This also applies to some healthcare providers who may not screen effectively for addiction because their views are skewed due to societal stigma around addiction.

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The Americans With Disabilities Act And Addiction Treatment

The ADA was established on July 26, 1990, and prohibits discrimination against persons with disabilities, ensuring they have the same opportunities and rights as everyone else to engage in the activities of general society.

The ADA protects people who have an addiction and are currently in treatment or have completed treatment in the past, though current illegal drug use is not protected under the ADA.

The ADA encourages people with an addiction to enter into recovery, and they do this by granting them certain protections with their employer. For example, people who seek addiction treatment are legally granted a leave of absence from their employer without losing their job. By law, their employer must make reasonable accommodations for them, as long as they are not currently using drugs and are still meeting job performance standards.

Find A Treatment Center

Individuals living with a disability and co-occurring addiction may struggle with underlying emotions and challenges that are unique to this population. They may have several questions about treatments, ADA-compliant treatment centers, accessibility, medications, and disability services. Contact a treatment provider or visit our rehab directory today to explore your many treatment options.