Addiction and Disabilities: A Guide for Families and Loved Ones
- Content Reviewed By:
- Andrew McKenna - JD
- Deputy Director of NCADD Westchester
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Addiction and Disabilities: A Guide for Families and Loved Ones
Addiction is a disease characterized by compulsive substance abuse. A study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) found that about 10% of U.S. adults have experienced a drug use disorder at some point, with 4% having occurred in the previous year.
While anyone is at risk of addiction, evidence suggests an increased likelihood of co-occurrence among those with conditions like mental or physical disabilities. The nature of the disability affects the exact way this complication manifests, such as causing the user to take habit-forming drugs, or inhibiting their ability to exercise self-control.
With this guide, you can increase your understanding of co-occurring disabilities and Substance Use Disorders. Additionally, you’ll learn more about treatment options, covering the cost of care, and resources to help your loved one recover from addiction.
People can experience many types of disabilities, each affecting their lives in a different way. At their most basic level, disabilities can be divided into physical and mental impairments; however, there is a large assortment of potential disabilities within those classifications.
In the U.S., the Social Security Administration regulates what is considered a disability. According to U.S. law, a disability is an observable physical or mental impairment that affects a person’s ability to work or engage in activities that provide a livable income.
Types of Disabilities
Each disability is unique in its effect on a person’s life, but many can be categorized in a general sense. Furthermore, the causes, symptoms, and severity may be diverse, but they are all similar in that they have the potential to alter one’s lifestyle.
- Physical disabilities: A physical disability limits a person’s ability to move or otherwise control their body. These can come from injuries, amputations, or degenerative illnesses.
- Sensory disabilities: A sensory disability limits a person’s ability to hear and/or see.
- Cognitive disabilities: People with cognitive disabilities have difficulty learning and processing information, such as with autism spectrum disorder and dyslexia.
- Psychiatric disabilities: Psychiatric disabilities include depression, anxiety, schizophrenia, and other conditions that affect mental and emotional well-being.
- Chronic health conditions: A chronic health condition is generally one that is difficult to, or not presently possible, to cure. These conditions can impact physical, mental, or emotional health, and include such conditions as diabetes and HIV/AIDS.
- Developmental disabilities: These disabilities affect a person’s ability to develop and learn skills. Examples include Fetal Alcohol Syndrome (FAS) and Down Syndrome.
It is also possible for a person to experience multiple disabilities at the same time. In some cases, such as a degenerative illness, one disability may even lead or change into another. Other disorders can co-exist with disabilities as well, bringing even more complications.
For example, chronic pain can be difficult for people with disabilities. This is especially true for those with physical disabilities when the pain further limits mobility. Moreover, medications to treat chronic pain can be dangerous and potentially habit-forming. It can be difficult to learn to manage pain responsibly, especially when that pain has the potential to be debilitating.
Co-occurring Disorders Among People With Disabilities
A co-occurring disorder is a combination of mental illness and substance use disorder. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) resource cited above, people with disabilities are more likely to experience mental illness and are more likely to develop substance use disorders. Co-occurring disorders are common among those in treatment for substance misuse.
Substance Misuse Risk Factors for People With Disabilities
For people with disabilities, there are several risk factors that can contribute to substance misuse. Everyone’s experience is different, so not all people with disabilities will have these risk factors.
- Limited education and academic difficulties: People with disabilities may have limited access to education or information regarding the risks associated with substance abuse, which could make them more likely to experiment with illicit substances.
- Mental health conditions: People with disabilities are more likely to experience conditions such as depression and anxiety. These people may self-medicate by using addictive substances.
- Chronic or persistent pain: Many people with disabilities experience chronic or continuous pain because of their condition. People in this situation may misuse pain medication to address pain, which can lead to addiction.
- Access to medication: Some people with disabilities may have access to larger quantities of medication due to their conditions. This can increase the potential for substance misuse.
- Lack of access to healthcare: Managing and treating substance misuse can be more difficult if a person’s disability prevents their access to healthcare.
- Communication barriers: Some disabilities may affect the ease of communication, which can make it more difficult to gain access to information about the risks of substance misuse or available treatment options.
- Stigma and discrimination: People with disabilities may face discrimination and stigma attached to their conditions. This can lead to social isolation and loneliness. Being excluded and facing negative attitudes from others can lead to poor self-esteem—which in turn, can drive people to substance misuse as a coping mechanism to manage resultant emotional stress.
- Lack of support: Some people with disabilities may have difficulties accessing peer support groups and counseling, which can increase the risk of substance abuse. They may also have a family member or caregiver who enables their addiction by ignoring warning signs or facilitating access to substances.
While these risk factors make it more likely for people with disabilities to misuse substances, they also highlight the importance of being proactive in recognizing and taking steps to avoid substance misuse.
Signs of Addiction
Substance misuse and addiction, more often than not, come with signs. Loved ones should learn to recognize these drug abuse indicators, in order to recognize when someone is struggling and may need help recovering. It’s especially important to look out for these symptoms in patients where risk factors are present.
- Physical symptoms: These can include changes in appearance, such as extreme weight changes, skin discoloration, or dental issues.
- Psychological symptoms: Potential psychological symptoms include mood swings, hallucinations, increased anxiety, agitation, and depression.
- Behavioral symptoms: Changes in behavior include lying and deception, high-risk behavior, changes in friendships, becoming withdrawn from work, school, and other social gatherings.
Some of these signs may be difficult for loved ones to notice, especially if they aren’t in regular contact. However, these symptoms could be indicators of a serious problem, so keeping an eye out for any of these clues could be a life-saving gesture.
Substance Use Treatment and Recovery for People With Disabilities
There are a number of treatment options for people with disabilities looking for help recovering from substance misuse issues. Each has its own benefits and considerations that can make it more, or in some cases less, effective for your situation.
- Inpatient programs: Also known as residential treatment, inpatient programs involve living at a treatment facility for a period of time while receiving treatment for substance abuse. These programs feature 24-hour support and a structured schedule, which can be helpful for those with severe substance abuse issues.
- Outpatient programs: Patients in outpatient programs continue to live at home while receiving substance abuse treatment. Each facility has its own specific approach to treatment. Some may require daily treatments, while others may only require weekly sessions. Some facilities may even offer online telehealth check-ins which can be useful for those with limited mobility. Outpatient programs can be helpful for those with less severe substance abuse issues who have responsibilities such as work to consider.
- Partial hospitalization programs (PHP): Providing a level of treatment between inpatient and outpatient, PHPs offer treatment during the day, while allowing patients to return home in the evening. PHPs typically provide a few hours of treatment a day for several days a week.
- Private alcohol and drug rehab: Privately owned treatment facilities offer services for substance abuse. These facilities can sometimes offer more luxurious accommodations than publicly funded facilities, but they can be more expensive.
- Relapse prevention drug rehab facilities: A relapse prevention facility focuses on helping people stay sober after the successful completion of another treatment program. These facilities offer peer group sessions, therapy, and other types of support for maintaining sobriety.
- Sober living halfway house drug rehab facilities: In a sober living halfway house, patients in recovery have access to a shared living space. These housing arrangements typically have rules and guidelines that support sobriety, such as drug testing, mandatory support group sessions, and individual therapy. These facilities can be especially helpful for those who are transitioning from a program for severe addiction and need a supportive living environment to continue their successful recovery and treatment.
Ideally, treatment should be tailored to an individual’s needs and may involve a combination of treatments. However, lack of access and availability may limit their options to the most accessible facility.
Barriers to Substance Recovery for People With Disabilities
Unfortunately, sometimes finding accommodating recovery services can be hard for those who need them most. Potential barriers can include several physical, mental, and financial complications.
- Additional financial hardships: If a disability prevents you from working, that puts limitations on your spending abilities. Even if you qualify for disability assistance, it’s entirely possible that money is already being spent elsewhere on other essentials.
- Lack of resources or programs that cater to those with disabilities: Existing and locally offered programs may be designed in such a way that they ignore or fail to address the specific considerations that impact people with disabilities. This can include a lack of Braille accommodations or lack of access to a sign language interpreter for individuals who are deaf or hearing impaired.
- Physical barriers at rehab centers for drugs or alcohol: Substance abuse rehab centers may not be designed with accessibility in mind, making it potentially difficult for those with disabilities to access. For example, a facility may have areas that are inaccessible to wheelchairs.
- Social isolation: Some people with co-occurring disorders may become withdrawn from friends and loved ones, which can make it difficult for them to gain access to the help they need.
Each of these potential barriers makes recovery difficult and can lead to additional challenges.
Covering the Cost of Treatment and Recovery
One of the biggest potential hurdles for recovery is finding a way to pay for the costs. Rehab and recovery centers can be expensive, and coupled with a disability that affects your income, the costs of treatment can seem insurmountable. Fortunately, there may be options for receiving financial assistance.
Does Private Insurance Cover Treatment?
Each private insurance plan offers different benefits, but generally, private plans will cover some form of treatment for addiction recovery. Legislation has also made mental health and substance misuse coverage required for Affordable Care Act Marketplace plans.
It’s important to consult with an insurance representative to see exactly which treatments are covered before weighing your options.
Government-funded Drug Rehab
Some communities may also have publicly funded drug rehab programs. These facilities may offer vouchers or more affordable treatment options than private facilities. Or they may provide funds in situations where insurance doesn’t cover the full cost of treatment.
Does Medicare Cover Treatment?
Medicare doesn’t specifically offer treatment for substance abuse and recovery, but it will cover some treatments when they’re deemed necessary. These include inpatient and outpatient programs, as well as PHPs.
Does Medicaid Cover Treatment?
Medicaid funding for substance abuse treatment varies from state to state. Some may offer more options for treatment than others, but all states will at least offer Medication Assisted Treatment for opioid addiction.
Understanding the ADA, Treatment, and Recovery
The Americans with Disabilities Act (ADA) is a law meant to protect the rights of people with disabilities and ensure they have access to equal opportunities. The law’s purpose is to prevent discrimination against people with disabilities by ensuring protections in housing, transportation, employment, and public accommodations. The law is made up of several titles, with Titles II and III relating to treatment and recovery for people with disabilities.
ADA Title II
Title II prohibits discrimination against disabilities by state and local governments in their programs, activities, and services. This ensures that government-run programs cannot deny a person with a disability access to a program due to their condition.
ADA Title III
Title III of the ADA prohibits discrimination in public places, including privately owned businesses or nonprofit organizations that are open to the open to the public. This ensures that government-run programs cannot deny a person with a disability access to a program because of their condition.
Can Addiction Cause a Disability?
Addiction and substance abuse can result in disabilities. For example, abusing substances can cause chronic health conditions such as liver damage, heart disease, and respiratory problems, each of which can lead to physical disabilities.
Substance abuse can also cause mental health disorders like depression and anxiety, which can lead to or intensify a disability. People under the influence of substances are also more likely to suffer serious injuries such as car accidents, which can result in disability.
Is Addiction a Disability?
Addiction to substances may be considered a disability in the eyes of the law. When addiction to a substance limits an individual’s ability to perform certain life activities, such as walking, breathing, or thinking, it can be considered a disability.
However, an individual’s specific circumstances will be considered when determining whether resulting deficits amount to a disability. Things such as current and active illegal drug use may also limit a person’s ability to obtain disability benefits.
Additional Addiction Resources
The following pages and resources offer support for those coping with substance abuse as well as for their loved ones:
- SAMHSA National Helpline: The Substance Abuse and Mental Health Services Administration offers a free, confidential helpline that offers around-the-clock information and referrals for individuals and families dealing with Substance Use Disorders.
- Growing Up Drug Free: A Parent’s Guide to Substance Use Prevention: This guide offers guidance for parents on providing their children with proper education regarding the dangers of alcohol, tobacco, and other drugs.
- CDC Recovery Is Possible: This guide discusses the signs of opioid addiction and options for treatments, and it provides resources and supplementary information regarding recovery.
- Treatment and Recovery Fact Sheet: This publication provides a concise guide to opioid addiction and treatment, along with some links to find treatment and recovery programs.
Additional Disability Resources
These pages provide resources that people with disabilities and their caregivers and loved ones can use for support and assistance:
- Disability Civil Rights: This guide from the U.S. Department of Health and Human Services discusses some of the civil rights protections offered to people with disabilities.
- Administration for Community Living: This page offers resources and online tools for people with disabilities, including services that promote independent living.
- Ready.gov: This page provides information and resources for helping people with disabilities prepare and respond to traumatic events and disasters.