Treating an Alcoholic Who Is Differently Abled
The term differently abled was devised in 1980 by the United States Democratic National Committee in an attempt to find a more suitable term to replace the terms handicapped or disabled.
Physical Accommodations for People Who Are Differently Abled in Treatment Situations
According to the statutes of the American With Disabilities Act, all commercial facilities, private accommodations, etc., that are not residential facilities are required to remove barriers to access and communication that would deferentially affect those who are differently abled. Most commercial and public facilities have some type of access designed for people who are differently abled. Private residences are not covered under the act.
Thus, most treatment facilities will have some accommodations for individuals who are differently abled in order to give them access to the facility and to move around it. If there is a problem with a particular public facility, a representative can contact that facility and have special accommodations made to allow them access to the facility.
Substance Use Disorders in People Who Are Differently Abled
Previous research has indicated that substance abuse is a problem for people with physical, cognitive, or psychological disabilities. The actual figures or estimates of the rates or prevalence of substance use disorders in people who are differently abled are not readily available; however, in 2011, the United States Department of Health and Human Services Office on Disability reported that nearly 75 million people in the United States have some form of disability. In addition, nearly 5 million adults have both a disability and a co-occurring substance use disorder. Based on these figures, about 7 percent of the differently abled population struggles with substance abuse.
While these rates are comparable with the general population, people who are differently abled may not access treatment for substance abuse at the same rate as people without disabilities. For instance, a research study published in the American Journal of Drug and Alcohol Abuse has suggested that people who are differently abled use drugs and alcohol at least as often as the general population and perhaps even more often; however, they have less access to treatment, even though treatment outcomes for differently abled people are similar to those in the general population.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute of Health (NIH), risk factors that affect differently abled individuals, and the particular type of substance that a differently abled person abuses, depend on the specific type of disability that is involved. When a disability involves chronic pain, opiate drugs and alcohol are often substances of choice. When a disability results in decreased mental functioning, other substances like stimulants may also be involved. Alcohol is one of the most common substances of abuse among the differently abled because of its availability, social acceptance, and central nervous system depressant effects.
The risk factors associated with the development of a substance use disorder among of the differently abled include:
- Unemployment and low income
- Chronic pain and other chronic physical issues
- Mental illness, which is always a risk factor for developing a substance use disorder
- Easier access to prescription medications
- Less access to education
- Social isolation
- Physical abuse and sexual abuse
- Enabling behaviors by caregivers
Recommendations to Increase Access to Treatment for Differently Abled Individuals
SAMHSA recommends that there are four fundamental categories of barriers to treatment for differently abled individuals that should be addressed:
- Attitudinal barriers
- Communication barriers
- Discriminatory practices and procedures
- Architectural barriers
SAMHSA believes that competent training of substance use disorder treatment professionals is key to eliminating many of these barriers, particularly attitudinal, communication, and discriminatory barriers. All staff members who associate with clients should be trained in understanding the functional limitations of the different types of people who are differently abled, and in overcoming the barriers that limit treatment availability to these individuals. Training programs should reward staff members who find practical solutions to these issues.
Specific types of disabilities require specific adjustments to the treatment program, such as for individuals who are deaf, blind, have cognitive deficits, etc. Treatment providers should develop a working network of specialists who can accommodate individuals with specific types of disabilities.
- Providing special accommodations is not the same thing as giving special preferences or privileges; rather, it involves reducing barriers to equal participation in the treatment.
- When specific types of barriers cannot be eliminated, the treatment program should define alternative avenues to make its services available to those in need. This may include referring a client to another more appropriate source.
- When there is a question regarding the legitimacy of a request of a differently abled person for specific accommodation, treatment provider should consult disability experts to evaluate the situation.
- It is beneficial to integrate differently abled people into already existing treatment services that are used by nondisabled people for alcohol use disorders or other substance use disorders, if possible.
- Assessment and screening services should include proper techniques for assessing issues associated with those who are differently abled.
- Treatment services for people with differently abled should be provided by appropriately trained professionals.
The actual adjustments to the treatment protocol for an alcohol use disorder in a differently abled person would depend on the specific disability the person has. There are many different types of potential disabilities that could be addressed. Because it is virtually impossible to accommodate everyone, different treatment providers often specialize in providing treatment services for specific types of disabilities.
The overall treatment plan for an individual with an alcohol use disorder would still be followed; however, the actual application of each component of the treatment would need to be adjusted to suit the needs of the individual. This means that differently abled people with alcohol use disorders still require:
- Withdrawal management or medical detox services
- Medical management and medically assisted treatments
- Counseling and psychotherapy services
- Social support, including peer support groups
- Treatment for co-occurring disorders, if required
- Complementary and alternative forms of treatment, if appropriate
- Case management services and other adjunctive services, as required
According to SAMHSA, the adjustments made to the specific treatment protocol will depend on the disability in question. Individuals who are differently abled should be provided with resources that can direct them to proper treatment given their issues. Some potential resources include:
- The National Directory of Alcohol and Other Drugs Prevention and Treatment Programs Accessible to the Deaf
- Substance Abuse Resources & Disability Issues (SARDI)
- Addiction & Disabilities Education & Resource Guide
- National Association on Alcohol, Drugs and Disability, Inc. (NAADD)