Abstract
As many as one in four adults have a disability and up to one in 12 have addiction to alcohol or drugs yet little is known about their intersection or more broadly about substance use among people with disabilities. The complex interplay of social, economic, and health factors associated with disability are also risk factors for substance use, unhealthy use, and addiction. Disability stigma and stereotypes are common around substance use by disabled people and their ability to engage in treatment and recovery. Many people with disabilities abstain from alcohol and drug use yet rates of addiction are higher across most disabilities than among the nondisabled, with the notable exception of alcohol. Despite this, disabled people are less likely to enter addiction treatment than nondisabled people. Stigma and other barriers to treatment are common for all people with substance use problems and more so for people with disabilities. Attitudes, discriminatory policies or practices, communications, and physical constraints reflect ableism and affect the ability of people with disabilities to enter addiction treatment. Once treatment is initiated, success can be maximized by meeting specific disability-related needs. For people with physical and sensory disabilities, if physical accessibility and communications accommodations are met, success in addiction treatment presumably should parallel that of people without these disabilities. For people with intellectual, developmental, and cognitive disabilities, success may require additional adaptations. Promising approaches exist but cross-systems training and collaboration is essential. By reducing ableism, misbeliefs, and stigma and offering flexible treatment approaches along with the required accommodations, people with disabilities who also have addiction should be supported in reducing unhealthy substance use and in their paths to recovery.