Drug and Alcohol Rehab for the Disabled

People with cognitive or physical disabilities have higher rates of substance use disorders and lower prevalence of getting treatment than other people.¹ Those with disabilities may start misusing substances in an attempt to reduce chronic pain, disability-related stigma, social isolation, or the psychological effects of trauma.¹ Substance abuse treatment centers offer increased opportunities for people with disabilities, such as: ²

• Relevant, up-to-date assistive technology.
• Accessible physical environment for everyone.
• Knowledgeable staff.
• Services that enable the participation of people who have a disability.

Those with disabilities who enter rehab for drug or alcohol addiction can experience many benefits.² Effective care will include help for addiction as well as any physical, psychological, social, or work-related problems that a patient is going through.²

This article will discuss barriers to addiction care for disabled people, risk factors for the development of substance misuse, detox, different levels of care, health insurance, as well as how professionals can help and in what types of settings. It also provides help in finding the right rehab center, which is an important part of treatment recovery.³

Barriers to Addiction Treatment for the Disabled

Barriers are often present for a disabled person who is seeking addiction treatment services.¹ These issues can be social, financial, psychological, environmental, or physical.¹ Barriers may also relate to the facilities that provide treatment.¹ Examples of this include:

• Buildings, including entrances and parking, that do not provide accommodations for people using wheelchairs, such as facilities with no elevators or ramps.¹ This can include hallways that are too narrow and flooring that is uneven.⁴
• Lack of reading materials in an appropriate format, such as Braille or large print, for those with visual impairments, including blindness.¹
• Treatment approaches that are not suited or properly adapted for people with learning or intellectual disabilities, such as services that are not aligned with reading levels or cognitive abilities.¹
• Policies that do not accommodate the disabled population; for example, a facility that requires patients to be able to self-evacuate in case of emergency.¹
• Staff not knowing sign language or having the training to use relevant technologies to communicate with people with hearing difficulties.¹

Risk Factors of Disability and Substance Use Disorder

Drug and alcohol addiction and disability can go hand-in-hand, as people with disabilities are confronted with numerous risk factors for substance use disorder.⁵ One potential risk factor is one’s financial situation, as this population faces higher rates of unemployment and lower income.⁵

Additional risk factors can include chronic physical pain, as well as depression and isolation that relate to some disabled individuals’ personal limitations in cognitive skills and ability to exhibit adaptable behaviors that directly affect everyday skills.^1,5

For example, consider a case of a man who was recently in a car accident and confined to a wheelchair. He may be feeling depressed, isolated, experiencing significant pain, and in need of pain medication. This combination of disadvantages could potentially increase the risk of developing a substance use disorder.

How Addiction Professionals Can Help the Disabled

Some facilities may be better equipped than others to provide drug rehab for disabled people.¹ Tips for helping individuals with physical disabilities obtain the best addiction treatment possible include:¹

• Providing breaks for patients who cannot sit for prolonged periods of time.
• If a patient is utilizing a sign language interpreter, reminding others present to take turns talking and directly addressing the hearing-impaired person instead of their interpreter.
• If a patient is blind, letting others know to make that person aware when they are joining or leaving activities such as group meetings.

Ways to improve service for people with cognitive disabilities include:¹

• Minimizing audio and visual stimuli that could be distracting.
• Providing an option for shorter, more frequent sessions.
• Giving reminder summaries of the previous session and repeating key points.
• Getting input from patients’ loved ones or caregivers about preferred learning styles and individual strengths, such as preferences for visual learning or smaller group sizes.
• Providing breaks when needed.
• Regularly checking in to assess understanding of important information.

In addition, telehealth may assist in engaging patients in rehab treatment due to its ability to provide increased access as well as convenience.⁶ Multiple studies have shown that telehealth is as effective as in-person treatment, as measured by rates of retention in therapy, perceived therapeutic alliance, and levels of substance abuse.⁶ It also significantly eliminates transportation barriers.⁶

Drug and Alcohol Rehab Settings for the Disabled

The American Society of Addiction Medicine (ASAM) criteria provide guidance in choosing the appropriate level of substance use treatment across a continuum of services.⁷

The ASAM levels of care are:⁷

• Prevention/early intervention.
• Outpatient care (Level 1).
• Intensive outpatient/partial hospitalization (Level 2).
• Residential/inpatient (Level 3).
• Intensive inpatient (Level 4).

Scientific studies have shown that detox and subsequent linking of patients to appropriate levels of care leads to increased levels of recovery.⁸

As mentioned previously, substance use disorders can be effectively treated via telehealth treatment.⁶ Telehealth can take different forms and offer various aspects of treatment including intake assessment, individual counseling, group therapy, and intensive outpatient services.⁶

Detox for the Disabled

Inpatient or outpatient detoxification entails withdrawing from alcohol or drugs with the aid of medical supervision.⁴ It facilitates the removal of toxins from a patient’s body who has experienced acute intoxication.⁸

The three key elements of the detoxification process for those seeking substance use treatment are evaluation, stabilization, and fostering patient readiness for and entry into treatment.⁸

While detoxification and withdrawal management are important and can be lifesaving, they are not substitutes for more comprehensive rehabilitation and treatment efforts.² Furthermore, professional treatment providers should be trained in the proper level of withdrawal-management services to prevent life-threatening symptoms, including overdose and death.⁸

Alcohol can be particularly dangerous to detox from, as alcohol withdrawal can lead to serious illness and death.⁹ Events that can present with acute alcohol withdrawal include seizures and delirium tremens (characterized by the experiencing of disorientation, hallucination, and confusion).⁹ Psychiatric problems that are associated with the withdrawal from alcohol include sleep disturbances, lowered mood, and anxiety.⁹

Detox and withdrawal from sedatives and opiates can also be dangerous to the extent they often necessitate hospitalization or a related form of 24-hour professional care.⁸ Treatment placement and length are often dependent on which substance is being misused and to what extent.⁸

Inpatient Addiction Treatment for the Disabled

One approach to treatment is to provide patients with inpatient or residential rehab programs.¹⁰ These services can be especially effective for people with more severe concerns, such as co-occurring disorders, health issues, lack of family support, and history of relapse.¹⁰ They offer 24-hour licensed and intensive treatment provision, which includes medical supervision along with safe and comfortable housing.¹⁰

Both short-term and long-term residential programs provide patients with a structured living center that provides the necessary skills to enter their community in a productive way once treatment is completed.⁴ Treatment generally lasts from 6 months to one year in length.¹⁰

Another option is short-term residential treatment.¹⁰ This provides a patient with detox services, intensive therapeutic services, and preparation to transition back into the community.¹⁰

Outpatient Drug and Alcohol Rehab Settings

Outpatient treatment includes interventions such as individual and group counseling focused on substance misuse.⁴ Treatment is often intensive at first, consisting of multiple sessions per week.¹⁰ After this, patients may transition to a schedule of less frequent and shorter treatment hours per week.¹⁰ Unlike inpatient treatment, patients can continue living at home while attending an outpatient treatment program.¹⁰

Outpatient treatment typically costs less than inpatient or residential treatment and is often the best option for people who have full-time jobs or significant social support.²

Intensive Outpatient Programs (IOP)

Intensive outpatient programs (IOPs) are an important element of the continuum of care that is available for those seeking help for substance misuse.¹¹ These programs have been shown to be as effective as inpatient treatment.¹¹

With an intensive outpatient program, patients are able to live and work in their regular environments.¹² Since these places are often the location of frequent relapse triggers, IOPs provide resources to improve problem-solving, assign homework, and facilitate role-play during individual and group counseling; these activities serve to present patients with opportunities to gain new cognitive abilities, coping skills, and healthy behaviors.¹²

Common treatment elements present in an IOP include the following:¹²

• Motivational interviewing.
• 12-Step groups and other self-help and mutual-help groups.
• Contingency management.
• A therapeutic community providing positive reinforcement.
• Cognitive behavioral therapy (CBT).

To best service the disabled population, material such as cognitive behavioral training may be modified to suit those with cognitive disabilities.¹²

Group sessions are the foundation of most IOPs and teach patients life skills, psychoeducation, and positive interaction in interpersonal situations.¹³

Partial Hospitalization Programs (PHP)

Partial hospitalization programs are a level of care that falls above outpatient and intensive outpatient services and below inpatient and residential treatment.⁷

Because services are not being provided in an inpatient setting, treatment duration may be longer for a PHP.¹¹ Partial hospitalization programs allow people to continue living at home, which may aid in recovery by facilitating patients’ adjustments back to living in their community.¹¹

A PHP is often suited for people struggling with substance misuse who do not meet severe enough criteria for inpatient or residential care; they also serve people who have completed a 24-hour care program and continue to necessitate a higher level of treatment than outpatient services.¹¹

Sober Living for the Disabled

Sober living homes are living environments free of alcohol and drug use that are for people working to abstain from substance use.¹⁴ Research has shown that residents of these homes have exhibited long-term accomplishments related to lowered substance use, symptoms of mental illness, and unemployment and incarceration rates.¹⁴

While staying at a sober living home, a patient will continue to participate in numerous treatment services.¹⁵ Outpatient treatment is often a crucial component of the program.¹⁵ In terms of where sober living falls along the continuum of care, these settings are far less restrictive than those experienced at a residential treatment program, although structure is still a foundation of the program.¹⁴

Benefits of this type of living environment include the prohibition of any drug or alcohol use, recommendation or requirement to attend 12-Step meetings such as Alcoholics Anonymous (AA), and often no limit as to how long a resident can remain in the living facility.¹⁴ Multiple services are provided to patients staying at sober living homes, including meal provision, onsite AA meetings, and educational classes.¹⁴ Additional benefits include the provision of peer support in the recovery process.¹⁵ and the presence of a support community.¹⁴ Since some patients are low income or have experienced homelessness, sober living houses can be a significant support by providing a stable and sober living environment.¹⁵

Does Insurance Cover Addiction Rehab for the Disabled?

All health plans under the Affordable Care Act (ACA) cover 10 listed essential health benefits, which include services for mental health, behavioral health, and substance use disorders.¹⁶ Each health insurance plan is different and coverage should always be verified, as benefits depend on location and one’s particular health plan.¹⁷ Factors such as co-pays, deductibles, out-of-pocket fees, list of providers in-network vs. out-of-network, and HMOs vs. PPOs all affect the cost of services.

You can reach American Addiction Centers (AAC) at to verify health insurance benefits and coverage details. Many health insurance plans pay for drug and alcohol rehab, and most should cover at least some of the costs of treatment.

Finding a Rehabilitation Center for the Disabled

Family and friends may be helpful to talk to about addiction treatment, as they often take on crucial roles in motivating loved ones to begin and stay in treatment.² Other steps that can be taken to find a rehab facility include talking to a doctor, visiting the Substance Abuse and Mental Health Services Administration (SAMHSA) website, or reaching out to an Employee Assistance Program (EAP).²

Treatment providers should inform potential patients of the ability of their services to provide for a range of access needs.¹ This will help ensure that people with disabilities are able to get the best possible care for their substance use concerns.¹

When considering which rehab location to choose, it can be helpful to remember several steps for successful treatment, to ensure that the facility provides them.¹⁰ These include:¹⁰

• Detoxification services.
• Medication (as needed for addiction to alcohol and opiates).
• Treatment for existing co-occurring mental health disorders.
• Long-term aftercare to lower or eliminate risk of relapse.

The AAC admissions navigators can help you or your loved one find a treatment facility that offers the services that are needed. Assistance is available 24 hours a day. It may be helpful to discuss some of the accommodations offered for people with disabilities to find the best treatment option available.

Getting Addiction Help for the Disabled

Addiction is a treatable disorder.² Benefits of receiving treatment for a substance use disorder include motivation to change, improved ability to cope with difficult situations, learning positive reinforcement skills to remain sober, improved interpersonal relationships, and overall increased well-being in life.²

If you or someone you know is struggling with addiction, support and assistance are available now to aid in beginning the substance use disorder treatment process. There is no better time than now to reach out for help. Call .