Around one out of every 12 adults in the United States struggles with alcohol abuse or dependence, the National Council on Alcoholism and Drug Dependence (NCADD) reports, as alcohol is the most regularly used addictive substance in America. Rates of substance abuse and addiction may be even higher among those who also suffer from a physical disability.
The American Foundation for the Blind (AFB) publishes that, in 2015, nearly 24 million Americans aged 18 and older reported some form of vision loss. A person who suffers from vision loss or blindness may turn to alcohol to self-medicate difficulties and stressors that can arise as a result of the physical disability. The journal Disabled World publishes that people who suffer from disabilities are between two and four times more likely to also struggle with substance abuse than the general public, and 40-50 percent of those with vision impairments may be classified as heavy drinkers.
Drinking alcohol in and of itself may not be that much of a big deal; the National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that nearly 90 percent of all American adults report alcohol use at some point in life as of a 2015 national survey. Adults of the legal drinking age of 21 may enjoy alcohol responsibly and without issue. Drinking to excess, however, can create a wide range of potential consequences, and there may be additional complications for someone who is blind.
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Issues Surrounding Alcoholism and Vision Impairment
The legal definition for blindness, as published by the National Federation of the Blind (NFB), is when a person has a vision acuity of 20/200 or less in their best eye even with corrective measures, or when the visual field is 20 degrees or less. This may mean that a person can see a little bit, discern the difference between light and dark only, or have complete vision loss.
Blindness can occur for a variety of reasons, such as macular degeneration, injury, illness, genetic condition, or infection. An individual may be born blind, experience an illness or injury that causes vision loss, or battle a condition that causes vision to become impaired. Regardless of the cause of blindness, someone who is blind has significant difficulties seeing and is generally considered to therefore be physically disabled.
A physical disability may cause a great deal of stress and produce a host of difficulties that others may not comprehend. Alcohol may seem like a temporary escape, offering a brief respite from daily struggles.
Alcohol is a drug that produces mind-altering effects that can further impair a person's coordination and balance, which may already be affected by visual impairment. When a person is blind, they commonly learn to rely on their other senses to survive. Alcohol dampens these other senses and may therefore increase the possible side effects of blindness and alcohol. Drinking too much dulls the senses, impairs judgment, and interferes with motor skills. As a result, alcohol abuse can increase a person's risk for the following:
- Being involved in an accident
- Becoming injured
- Being the victim or perpetrator of a crime or sexual assault
- Engaging in potentially risky sexual behaviors
- Suffering from possibly life-threatening alcohol poisoning
- Alcohol dependence and addiction
Regular episodes of excessive drinking increase the potential side effects of alcohol and elevate the odds for alcohol-related fatalities or addiction. The Centers for Disease Control and Prevention (CDC) reports that nearly 90,000 people died each year between 2006 and 2010 from excessive alcohol use.
Drinking more than four drinks per day (or 14 in a week) for a man or three drinks per day (seven in a week) for a woman is considered high-risk drinking by NIAAA. Drinking alcohol impedes the brain's natural functions, interfering with the natural movement of its neurotransmitters, or chemical messengers.
Drinking to excess on a regular basis can actually impact the normal chemical balance of the brain and cause a person to become dependent on alcohol. Alcohol dependence usually comes with difficult withdrawal symptoms when alcohol wears off, which can make it harder to stop drinking.
An inability to stop drinking, or an inability to control how often and how much is consumed in a sitting, can indicate alcohol addiction. Around 15 million adults in the United States suffered from alcohol addiction in 2015, NIAAA publishes.
Overcoming Treatment Barriers
There is a massive treatment gap among those who need treatment for addiction and alcoholism, and those who actually receive it. The American Society of Addiction Medicine (ASAM) estimates that around one out of every 10 Americans who battle addiction actually receive treatment.
There are many possible reasons for this staggering treatment gap. Many people who battle addiction are unwilling to admit or recognize that a problem exists, and others may cite family, work, or school obligations as barriers to treatment. A lack of insurance, worry about costs, or lack of accessible treatment options can also be reasons that a person may not get the help they need. People also often struggle with how others will perceive their need for addiction treatment.
Family members may enable their loved ones who are physically disabled, allowing them more concessions about their drinking than they may an able-bodied relative, allowing alcoholism to go unchecked for longer. When a person is blind and also battles alcoholism, stigma may be even greater, and an individual may struggle to find trained professionals who are understanding and empathetic.
Even though treatment facilities are required to meet certain standards, as set forth by the Americans with Disabilities Act (ADA), not all programs meet the necessary criteria. Treatment materials may not be accessible to those who are visually impaired. For instance, many treatment modalities include films, booklets, and visual communication tools that are sight-based and therefore inaccessible to someone who is blind.
There are several things that a treatment program can do, or provide, to ensure that people struggling with vision impairment and co-occurring addiction receive the highest level of care. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that treatment accessibility can be enhanced by Braille signs and other navigational features designed to help individuals who are visually impaired, and alternatives to sight-based counseling treatment activities should be available.
Group therapy and counseling sessions made up of people who also are visually impaired can help to provide specific life skills and coping mechanisms for this demographic. Staff members who are specifically trained in treating co-occurring disorders and the circumstances unique to this demographic are also very beneficial.
People who suffer from physical disabilities may also suffer from mental health disorders and issues with gainful employment at higher rates than the general public, and specialized treatment programs catering to this demographic are needed. Support groups that include other people who are blind can provide a network of people who can relate to each other and who face similar challenges. Peer support can go a long way toward sustaining recovery and helping to minimize relapse. Blindness and alcoholism can both be socially isolating, and creating healthy peer support networks can improve one’s overall quality of life.
It is important to check with a treatment facility beforehand to determine what level of care it can offer for someone who struggles with both alcoholism and blindness, and what special accommodations can be made.