Deaf and Hard of Hearing Addiction Treatment – An In-depth Guide

Content Reviewed By:

Andrew McKenna - JD

SUD treatment executive, national news contributor & keynote speaker.

Navigation:

• Overview
• The Scope of the Problem
• The Beginning: Common Causes of SUD in the DHH Community
• Mental Health Challenges
• DHH-Specific Lifestyle Risks
• Supporting DHH Community Members during their Treatment Journey
• Mental Health Resources for DHH Community Members
• The Importance of Supportive Loved Ones 

Overview

Individuals with total or partial hearing loss represent a significant portion of people struggling with substance use disorder. There is an established and growing body of research that indicates deaf and hard-of-hearing (DHH) populations are often at greater risk of alcohol and drug use than those with average hearing. As people with hearing impairments face unique risk factors for the development of alcohol and drug use in their everyday lives, they also face significant challenges before, during, and after their treatment experience.  

The Scope of the Problem

While alcohol and cannabis continue to be two of the most significant substance abuse threats facing the deaf and hard-of-hearing population, prescription misuse and illicit drug use also impact this community. In fact, some research indicates that members of the DHH community who are under 50 may be twice as likely to develop prescription opioid addiction as those with no hearing problems. 

The complex and often difficult journeys of DHH community members as they endeavor to navigate life come with potential pitfalls that can not only increase the likelihood of substance abuse but also make it harder to seek treatment and sustain long-term recovery. 

The Beginning: Common Causes of SUD in the DHH Community

From logistical and access barriers to social challenges and an overall sense of marginalization, the mental health needs of individuals who are deaf and hard-of-hearing must be met and addressed with care, diligence, and support at every stage of their journey. 

Mental Health Challenges

Trauma continues to be one of the leading drivers of substance use disorder and problematic drinking among members of the DHH community. Deaf and hard-of-hearing individuals report rates of trauma and post-traumatic stress disorder (PTSD) at rates nearly twice those of the general population. 

While the causes of these disproportionate rates of trauma often take root in childhood through bullying, social isolation, and lack of supportive community, deprivation of early language development, conflict in the family over education and communication methods, poor or inappropriate parental involvement, and low self-esteem form and be exacerbated in adulthood through factors such as intimate partner violence, sexual assault, and crime victimization, employment and general discrimination, and more. Other developmental trauma triggers may include barriers to accessing services in American Sign Language (ASL), which severely limits DHH community members’ options for escaping dangerous domestic situations and augmenting their general quality of life. 

Depression and anxiety are also urgent and escalating concerns among the DHH population that can trigger substance abuse. Data from Johns Hopkins University indicates that rates of diagnosis of depression and anxiety disorders are markedly higher among the deaf community than in those with average hearing abilities. Like trauma, the roots of these disparities are many and varied. Depression often stems from repeated incidents of marginalization, harassment, and discrimination. Anxiety, on the other hand, can stem from fears for safety, the inability to effectively communicate in case of emergency, and other complex feelings of fear. 

DHH-Specific Lifestyle Risks

Members of the DHH community commonly face barriers to effective communication. In addition to engendering isolation and frustration, it poses very real health and quality of life risks depending on the situation. 

This is most evident in their interactions with their medical providers, particularly when it comes to communicating important information about prescription medications. Several studies have pointed to the comparatively lower health literacy and higher rates of medication misuse among deaf and hard-of-hearing individuals. One study, in particular, points to communication with their pharmacy team as a barrier to proper understanding and adherence. 

A large contributor to the communication experience was the perception that the pharmacist was not being respectful. Regarding comfort taking medications, 12% of participants expressed a lack of understanding of medications while taking them. This led to participants essentially using online resources when seeking medication information.

Supporting DHH Community Members during their Treatment Journey 

When it comes to seeking treatment for substance use disorder, deaf and hard-of-hearing individuals face unique access barriers that render it more challenging to get help.

Some of these factors include, but are not limited to: 

• Lack of DHH-accessible resources at their prospective facilities
• Communication barriers with case management professionals and referral services
• Lack of sign-language options throughout the research process
• Anxiety and trust issues with care providers

Clinicians, referral specialists, and admissions professionals may be able to overcome these access barriers by: 

• Prioritizing pre-treatment outreach in a way that meets DHH community members’ language and cognitive challenges
• Establishing a dialogue of trust and mutual respect to alleviate concerns of discrimination and poor treatment
• Skill-building to help frame coping strategies and relapse-prevention mechanisms toward DHH patients’ unique experiences
• Continuing to empower patients in their journeys through encouragement and support

While it’s critically important for all members of all patients’ care teams to work collaboratively so they can measure patients’ progress, determine their ongoing needs, and continue to assess their challenges, this collaboration is particularly significant for DHH patients so no element of their care gets neglected or falls through the proverbial cracks. 

Mental Health Resources for DHH Community Members

• American Society for Deaf Children Resources
• University of Maryland Deaf Addiction Services
• National Association for the Deaf Mental Health Resources
• The Deaf Health Charity Mental Health Library 
• Deaf Counseling Center
• National Deaf Domestic Violence Hotline
• National Deaf Therapy Website 

The Importance of Supportive Loved Ones 

As important as it is to have a loved one help navigate the treatment process, it’s practically essential for DHH community members who will undoubtedly need help communicating their clinical needs, insurance information, and other pertinent factors to stakeholders as they look for treatment. If your loved one is a member of the DHH community and needs help for substance use disorder, one of the best ways you can support them is by helping them communicate during the treatment process. Your support and guidance are more valuable than you may realize.