Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover

In Brief

August 2011 • Volume 6 • Issue 1

Substance Use Disorders in People With 

Physical and Sensory Disabilities

Approximately 23 million people in the United 

States, including people with disabilities, need 

treatment for substance use disorders (SUDs), a major 

behavioral health disorder.1

 In addition, more than 

24 million adults in the United States experienced 

serious psychological distress in 2006.2

 People with 

and without disabilities may face many of the same 

barriers to substance abuse treatment, such as lacking 

insurance or sufficient funds for treatment services, or 

feeling they do not need treatment. 

In addition, people with disabilities may face other 

barriers to SUD treatment, particularly finding 

treatment facilities that are fully accessible. Vocational 

rehabilitation (VR) counselors, vocational education 

providers, and others who work with people with 

disabilities report that their clients with SUDs have 

less successful vocational outcomes than clients 

without SUDs.3

To improve outcomes, it is important that clients 

with disabilities and SUDs receive services for both 

conditions and that the disabilities do not prevent 

clients from receiving treatment for SUDs. This In 

Brief is intended to help people who work with people 

with physical and sensory disabilities—hearing 

loss, deafness, blindness, and low vision—to better 

understand SUDs and assist their clients in finding 

accessible SUD treatment services. 

What is an SUD? 

Substance use disorder is a broad term that encompasses 

abuse of and dependence on drugs or alcohol 

(Exhibit 1). It includes using illegal substances, such 

as heroin, marijuana, or methamphetamines, and using 

legal substances, such as prescription or over-the-counter 

medications, in ways not prescribed or recommended.

Exhibit 1. Defining Substance Abuse and Dependence

Both substance abuse and substance dependence refer to maladaptive patterns of substance use. Substance abuse usually refers 

to using any substance in a way that leads to a failure to fulfill major responsibilities at work, school, or home, or to substancerelated legal or interpersonal problems. It also includes using substances in situations that put one’s physical safety at risk. 

Substance dependence usually manifests as continued use of a substance despite negative physical or psychological effects, 

inability to cut down or control the use of the substance, tolerance (using more of the substance to get the same effect), and 

withdrawal symptoms when the substance is no longer consumed. The Diagnostic and Statistical Manual of Mental Disorders,

Fourth Edition, Text Revision (DSM-IV-TR)4 provides fuller definitions of substance abuse and substance dependence.

SUDs Harm People With 

Disabilities

It is difficult to estimate the number of people with 

physical disabilities who have SUDs. Some studies 

suggest that people with disabilities have higher rates 

of legal and illegal substance use than the general 

population, whereas other studies show lower rates.5

Although debate exists among researchers about the 

prevalence of SUDs among people with disabilities, 

there is agreement that active SUDs can seriously 
Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover

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In Brief
 

harm the health and quality of life of individuals with 

disabilities. An active SUD can: 

■		Interfere with successful engagement in rehabilitation 

services.3 

■		Interact with prescribed medications; alcohol, for 

example, can interfere with antiseizure medications. 

■		Impede coordination and muscle control. 

■		Impair cognition. 

■		Reduce the ability to follow self-care regimens. 

■		Contribute to social isolation, poor communication, 

and domestic strife. 

■		Contribute to poor health, secondary disabling 

conditions, or the hastening of disabling diseases 

(e.g., cirrhosis, depression, bladder infections). 

■		Inhibit educational advancement. 

■		Lead to job loss, underemployment, and housing 

instability.
	

Women With Disabilities and SUDs 

Across all age groups, more women than men are disabled.6 

Women with co-occurring disabilities and SUDs are at high 

risk for experiencing physical abuse and domestic violence. 

One study of people with disabilities and SUDs found 

that 47 percent of women reported histories of physical, 

sexual, or domestic violence, compared with 20 percent 

of men with disabilities reporting abuse experiences. In 

the same study, 37 percent of women reported sexual abuse, 

compared with 7 percent of men.7 

Another study found that 56 percent of women with 

disabilities reported abuse, with 89 percent of these 

reporting multiple abusive incidents.8 What is more, being a 

victim of physical or sexual abuse is a risk factor for SUD. 

SUD Risk Factors and Warning 

Signs 

For some people, drug or alcohol abuse is a direct or 

indirect cause of their disability, for example, by their 

becoming intoxicated and then falling or causing a car 

crash. Without SUD treatment, people who had SUDs 

before sustaining a disability will likely continue to use 

substances afterward. Other people may have developed 

SUDs after using substances such as pain medications or 

alcohol to cope with aspects of their disability or to cope 

with social isolation or depression. Exhibit 2 lists SUD 

risk factors for people with disabilities. 

Exhibit 2. SUD Risk Factors for People 

With Disabilities
 

■		Pain 

■		Access to prescription pain medications 

■		Chronic medical problems 

■		Depression 

■		Social isolation 

■		Enabling by caregivers 

■		Unemployment 

■		Limited education 

■		Low socioeconomic level 

■		Little exposure to SUD prevention education 

■		History of physical or sexual abuse 

Numerous signs may suggest the presence of an active 

SUD. These include, but are not limited to: 

■		Dilated or constricted pupils. 

■		Slurred speech. 

■		Inability to focus, visually or cognitively. 

■		Unsteady gait. 

■		Blackouts. 

■		Insomnia. 

■		Irritability or agitation. 

■		Depression, anxiety, low self-esteem, resentment. 

■		Odor of alcohol on breath. 

■		Excessive use of aftershave or mouthwash (to mask 

the odor of alcohol). 

■		Mild tremor. 

■		Nasal irritation (suggestive of cocaine insufflation). 

■		Eye irritation (suggestive of exposure to marijuana 

smoke). 
Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover

Substance Use Disorders in People With Physical and Sensory Disabilities

August 2011, Volume 6, Issue 1

■		Odor of marijuana on clothing. 

■		Abuse of drugs or alcohol by family members. 

■		Many missed appointments with VR, job interviews, 

and the like. 

■		Difficulty learning new tasks. 

■		Attention deficits. 

■		Lack of initiative. 

Some manifestations of certain disabilities may be difficult 

to distinguish from the signs of SUDs mentioned above. 

For example, people with multiple sclerosis may have an 

unsteady gait, slurred speech, and memory impairment. 

Other signs, such as depression or anxiety, may indicate a 

different, distinct behavioral health condition. 

Screening for SUDs 

Screening is not the same as diagnosing; it simply indicates 

whether further evaluation by an SUD professional 

is indicated. The National Institute on Alcohol Abuse 

and Alcoholism (NIAAA) developed a single-question 

screening tool for alcohol use disorder (Exhibit 3). Clients 

should also be screened for illicit drug use and prescription 

medication abuse. VR professionals, physical therapists, 

and others may benefit from training on how to administer 

screening and assessment tools. 

Exhibit 3. Single-Question Screening Test 

Ask men: “How many times in the past year have 

you had 5 or more drinks in a day?” 

Ask women: “How many times in the past year have 

you had 4 or more drinks in a day?” 

A response of more than 1 day is considered positive. 

Other common screening tools are: 

■		Alcohol Use Disorders Identification Test, available 

at http://www.projectcork.org/clinical_tools/html/ 

AUDIT.html 

■		Michigan Alcoholism Screening Test, available at 

http://www.projectcork.org/clinical_tools/html/ 

MAST.html 

■		Drug Abuse Screening Test (including prescription 

drugs), available at http://www.projectcork.org/ 

clinical_tools/html/DAST.html 

■		National Institute on Drug Abuse (NIDA)-modified 

Alcohol, Smoking, and Substance Involvement 

Screening Test, which includes prescription drugs, 

available at http://www.drugabuse.gov/nidamed/ 

screening/ 

Screening is not the same as 

diagnosing; it simply indicates 

whether further evaluation 

by an SUD professional is 

indicated. 

The Substance Abuse and Mental Health Services Administration (SAMHSA)/Center for Substance Abuse Treatment Family 

Centered Substance Abuse Treatment Grants for Adolescents and their Families (Assertive Adolescent and Family Treatment) was 

designed to provide substance abuse services to adolescents (including those with disabilities and those from military families) 

and their families or primary caregivers in geographic areas where services are needed. Grantees implement evidenced-based 

practices that are family centered and context specific and focus on the interaction between youth and their environments. 

No screening tools have been validated in Deaf populations.9 

If possible, clients who exhibit warning signs or symptoms 

should be screened for SUDs. If screening is not possible or 

if the screening is positive, the client should be referred to 

an SUD treatment provider for further assessment. 

Some clients may benefit from a brief intervention (a 

discussion of 5 minutes or less) to prevent their substance 

use from becoming an SUD. Information on brief 

interventions for alcohol use disorders is available from 

3 
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In Brief
 

NIAAA at http://pubs.niaaa.nih.gov/publications/AA66/ 

AA66.htm. Clients whose signs suggest a mental health 

issue should be referred to a professional for further 

assessment. 

Types of SUD Services 

SUD services include: 

■		Prevention education—information in various
	

formats that helps people understand the risks of
	

substance use.
	

■		Indepth assessment—an evaluation by a treatment
	

provider to determine whether an SUD is present
	

and, if so, what level of care is needed and what
	

treatment options are available.
	

■		Outpatient or inpatient detoxification—medically
	

supervised withdrawal from alcohol or drugs.
	

■		Outpatient treatment—psychosocial interventions
	

and individual and group counseling on substance
	

use.
	

■		Medication-assisted treatment and counseling— 

methadone, buprenorphine, and other medications 

for opioid dependence or acamprosate, disulfiram, 

and naltrexone for alcohol use disorders; medicationassisted treatment works best if combined with 

psychosocial counseling interventions. 

■		Residential programs—short- and long-term
	

structured living to help people re-enter their
	

community.
	

In addition, people in recovery often attend mutual-help 

groups, such as Alcoholics Anonymous (AA), Narcotics 

Anonymous (NA), and SMART (Self Management and 

Recovery Training) Recovery to share experiences and 

support one another’s recovery efforts. Many meetings of 

AA and NA that are wheelchair accessible are identified 

in meeting lists. Online meetings are an option for those 

who are Deaf and hard of hearing, people with visual 

disabilities, or people who live in locations without 

accessible meetings. Some AA groups will pay for a 

sign language interpreter or make use of sign language 

interpreters who are in recovery themselves. 

Barriers to Treatment for People Who Are Blind or Visually Impaired 

A survey of VR counselors and SUD treatment providers found that barriers to SUD treatment for people who are blind or visually 

impaired are formidable. Frequently identified barriers are presented below: 

■		Negative attitudes and prejudices about people with SUDs. Some VR professionals regarded people with SUDs and 

disabilities as “not worthy” of SUD treatment, particularly if outcomes are perceived as poor for people with these two 

co-occurring conditions. 

■		Lack of staff training. SUD counselors reported a need to learn about working with people who are blind, and VR counselors 

report a need to learn about SUDs in their clients. 

■		Inaccessible methods and materials. Many facilities that provide SUD services reported that they are “handicapped 

accessible” if they provide ramps for clients. But people who are visually impaired require Braille signs and other 

navigational features and alternatives to sight-based counseling treatment activities like films and booklets to have genuine 

accessibility to treatment services. 

Survey respondents noted it is important to identify which agency will coordinate comprehensive client care. Respondents also 

commonly mentioned that, because there are no formal mechanisms for shared communication and case management, SUD and 

VR services providers may not know how to manage cases and work together across fields to provide services for their clients.15 

Accessible SUD Treatment 

Facilities 

Despite requirements of the Americans with 

Disabilities Act (ADA), studies suggest that many 

treatment facilities are not fully accessible to people 

with disabilities.10, 11, 12, 13, 14 Examples of physical barriers 

include doors and hallways too narrow for wheelchairs, 

uneven flooring, nonfunctioning elevators, and a reliance 
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Substance Use Disorders in People With Physical and Sensory Disabilities

August 2011, Volume 6, Issue 1

on signage to provide directions, which leaves people with 

low or no vision without a means to find their way through 

facilities. 

Many other types of barriers exist. Some SUD treatment 

administrators believe that their facilities are more 

accessible than they actually are.14 Of various types of 

healthcare providers, outpatient SUD treatment providers 

are among the least likely to report that their services are 

accessible to people with disabilities or that they have had 

training on mobility impairments.10 

Comparatively little information is available on how many 

people with disabilities have been denied SUD treatment 

because of physical barriers in the treatment facility itself. 

One survey of 174 SUD treatment providers in Virginia 

found that 87 percent of people with multiple sclerosis, 

75 percent of people with muscular dystrophy, and 

67 percent of people with spinal cord injuries who sought 

services were denied SUD treatment services because of 

physical barriers at the treatment facility.13 

Treatment Innovations for People Who Are Deaf or Hard of Hearing 

Few fully accessible SUD treatment services exist for people who are Deaf. Specialty treatment facilities for people who are 

Deaf exist, but the number has declined in the last decade. In 2009, only five providers in the United States offered inpatient 

SUD services especially for people who are Deaf, and four provided outpatient treatment.16 A national survey in 2008 by 

SAMHSA found that 27 percent of opioid treatment facilities offered interpretation services for people who are Deaf or hard of 

hearing.17 However, there are numerous barriers to providing fully accessible mainstream SUD treatment to people who are Deaf, 

including cultural and linguistic barriers, lack of local SUD treatment providers trained to work with people who are Deaf, lack 

of American Sign Language interpreters, inability of people who are Deaf to participate in group counseling (a mainstay of SUD 

treatment), increased costs associated with making treatment accessible to people who are Deaf, and more.18 

One way to fill the treatment gap is to advocate telehealth SUD treatment services for people who are Deaf. Telehealth 

technology, such as electronic mailing lists and video conferencing, can connect people who are Deaf to appropriate SUD 

specialists across the country, and it can be adapted for an array of SUD services, from recovery support after treatment to 

mutual-help groups. Telehealth could also be used to train more people who are Deaf to be SUD counselors. One promising 

model piloted by Wright State University is Deaf off Drugs and Alcohol (DODA), a program for Ohio residents that supplements 

local SUD treatment with Internet- and video-based case management, group therapy, individual therapy, and followup. DODA 

also manages mutual-help/12-Step meetings available 7 days a week, which are conducted via video conferences and open to 

anyone in the country.18 More information on innovative SUD services for people who are Deaf is available at http://www.med. 

wright.edu/citar/sardi/doda.html. 

Ways to Help Clients With SUDs 

VR counselors, physical therapists, and others who work 

with people with disabilities are in a good position to 

understand the importance of identifying and treating 

behavioral health conditions, such as SUDs, and to 

advocate for their clients’ right to accessible SUD 

treatment services. To help clients with SUDs: 

1. Learn about behavioral health issues, such as SUDs, 

and promote prevention. A wealth of information about 

drug and alcohol use, abuse, and dependence and their 

consequences can be found online. 

■		Free ADA-compliant publications on SUDs can be 

downloaded from SAMHSA’s Publication Ordering 

Web page, at http://www.store.samhsa.gov/home 

■		Information about drugs of abuse is on NIDA’s Web 

site, at http://www.nida.nih.gov 

■		Information about alcohol use disorders is located on 

NIAAA’s Web site, at http://www.niaaa.nih.gov 
Behavioral Health Is Essential To Health • Prevention Works • Treatment Is Effective • People Recover

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In Brief
 

■		An overview on SUDs for VR counselors, Substance 

Use Disorders and Vocational Rehabilitation: VR 

Counselor’s Desk Reference, and other information on 

substance use and people with disabilities is available 

from Wright State University, at http://www.med. 

wright.edu/citar/sardi/products.html 

2. Don’t ignore signs of a possible SUD in clients with 

disabilities. When there is doubt that disability alone 

explains a sign or behavior, screen the client for an SUD or 

refer the client to a behavioral health specialist for further 

evaluation. SUD is a preventable and treatable condition. 

A nonjudgmental approach to giving feedback to clients 

about the potential consequences of their substance use 

can enhance their motivation to seek further evaluation and 

treatment. 

3. Build a directory of local treatment providers and 

facilities that work with or would be willing to learn to 

work with people with disabilities. SAMHSAʼs online 

Substance Abuse Treatment Facility Locator includes 

more than 11,000 U.S. treatment facilities. State-specific 

information is available at http://dasis3.samhsa.gov. 

Online recovery meetings are available in a variety of 

formats, including text-based chats and discussion forums, 

audio and telephonic meetings, and video meetings. 

Information about online meetings is available at: 

■		Alcoholics Anonymous Online Intergroup
	

http://aa-intergroup.org/index.php 

■		Narcotics Anonymous Chat and Online Meetings for 

Drug Addicts 

http://www.12stepforums.net/na 

■		SMART Recovery Online 

http://www.smartrecovery.org/meetings/olschedule.htm 

4. Where possible, help SUD treatment administrators 

understand how they can make their facilities 

accessible to people with disabilities. SAMHSA’s 

Treatment Improvement Protocol (TIP) 29: Substance 

Use Disorder Treatment for People With Physical 

and Cognitive Disabilities, was written to help SUD 

treatment providers work with people with cognitive and 

physical disabilities. Appendix D, in particular, is useful 

for advocating accessibility in treatment facilities. The 

TIP is available online at http://www.ncbi.nlm.nih.gov/ 

bookshelf/br.fcgi?book=hssamhsatip&part=A52487. A 

Quick Guide based on TIP 29 was created to help SUD 

treatment administrators comply with ADA requirements 

and better serve people with disabilities. The Quick Guide 

is available at http://www.store.samhsa.gov/product/ 

QGCT29. 

Other resources include: 

■		Baylor College of Medicine Center for Research on 

Women with Disabilities 

http://www.bcm.edu/crowd 

Click on “Secondary conditions.” From the resulting 

page, click on “Substance abuse.” 

■		Minnesota Chemical Dependency Program for Deaf 

and Hard of Hearing Individuals 

http://www.mncddeaf.org 

■		Wright State University Substance Abuse Resources 

and Disability Issues (SARDI) Program 

http://www.med.wright.edu/citar/sardi 

Many links are available from the SARDI home page. 

The “Materials” link offers access to several print 

resources available free or for a small fee. These 

include Substance Use Disorders and Vocational 

Rehabilitation: VR Counselorʼs Desk Reference; 

Substance Abuse, Disability & Vocational 

Rehabilitation; and Blindness, Visual Impairment, and 

Substance Abuse. 

5. Once a client enters treatment and is ready for VR, 

work with the client’s primary care physician, SUD 

case manager, and other treatment professionals to 

best serve the client. TIP 29 (Chapter 4) presents ideas on 

establishing linkages for case management. The chapter 

can be viewed at http://www.ncbi.nlm.nih.gov/bookshelf/ 

br.fcgi?book=hssamhsatip&part=A52886. 
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7 

Substance Use Disorders in People With Physical and Sensory Disabilities

August 2011, Volume 6, Issue 1

Resources 

TIP 29: Substance Use Disorder Treatment For People 

With Physical and Cognitive Disabilities, offers treatment 

providers guidelines on caring for people with either 

physical or cognitive disabilities, as well as drug abuse 

or alcohol abuse problems. The TIP discusses screening, 

treatment planning, and counseling, and links to other 

service providers (http://www.ncbi.nlm.nih.gov/books/ 

NBK14408/). 

Products based on TIP 29: 

KAP Keys for Clinicians Based on TIP 29: Substance 

Use Disorder Treatment for People With Physical and 

Cognitive Disabilities 

http://www.kap.samhsa.gov/products/tools/keys/pdfs/ 

KK_29.pdf 

Quick Guide for Clinicians Based on TIP 29: Substance 

Use Disorder Treatment for People With Physical and 

Cognitive Disabilities 

http://www.kap.samhsa.gov/products/tools/cl-guides/pdfs/ 

QGC_29.pdf 

Quick Guide for Administrators Based on TIP 29: 

Substance Use Disorder Treatment for People With 

Physical and Cognitive Disabilities 

http://www.kap.samhsa.gov/products/tools/ad-guides/pdfs/ 

QGA_29.pdf 

Notes 

1

 Substance Abuse and Mental Health Services Administration. 

(2010). Results from the 2009 National Survey on Drug Use 

and Health: National findings. NSDUH Series H-38A, HHS 

Publication No. (SMA) 10-4856. Rockville, MD: Author. 

2

 Substance Abuse and Mental Health Services Administration. 

(2007). Results from the 2006 National Survey on Drug Use 

and Health: National findings. NSDUH Series H-32, HHS 

Publication No. (SMA) 07-4293. Rockville, MD: Author. 

3

 Davis, S. J., Koch, D. S., McKee, M. F., & Nelipovich, M. 

(2009). AODA training experiences of blindness and visual 

impairment professionals. Journal of Teaching in the 

Addictions, 8(1), 42–50. 

4 American Psychiatric Association. (2000). Diagnostic and 

statistical manual of mental disorders (4th ed., text 

revision). Washington, DC: Author. 

5 Yu, J., Huang, T., Newman, L., & SRI International. (2008). 

Substance use among young adults with disabilities: Facts 

from National Longitudinal Transition Study 2. Washington, 

DC: Department of Education Institute of Education Science. 

6

 Centers for Disease Control and Prevention. (2009). Prevalence 

and most common causes of disability among adults— 

United States, 2005. MMWR, 58(16), 421–426. 

7 Wolf-Branigin, M. (2007). Disability and abuse in relation to 

substance abuse: A descriptive analysis. Journal of Social 

Work in Disability & Rehabilitation, 6(3), 65–74. 

8

 Milberger, S., Israel, N., Le Roy, B., Martin, A., Potter, L., & 

Patchak-Schuster, P. (2003). Violence against women with 

physical disabilities. Violence and Victims, 18(5), 581–591. 

9 Alexander, T. D., & Tidblom, I. (2005). Screening for alcohol 

and other drug use problems among the Deaf. Alcoholism 

Treatment Quarterly, 23(1), 63–78. 

10 Bachman, S. S., Vedrani, M., Drainoni, M. L., Tobias, C., & 

Andrew, J. (2007). Variations in provider capacity to offer 

accessible health care for people with disabilities. Journal of 

Social Work in Disability & Rehabilitation, 6(3), 47–63. 

11 Thapar, N., Warner, G., Drainoni, M. L., Williams, S. R., 

Ditchfield, H., Wierbicky, J., & Nesathurai, S. (2004). A 

pilot study of functional access to public buildings and 

facilities for persons with impairments. Disability and 

Rehabilitation, 26(5), 280–289. 

12 West, S. L. (2007). The accessibility of substance abuse 

treatment facilities in the United States for persons with 

disabilities. Journal of Substance Abuse Treatment, 33(1), 

1–5. 

13 West, S. L., Graham, C. W., & Cifu, D. X. (2009). Rates 

of alcohol/other drug treatment denials to persons with 

physical disabilities: Accessibility concerns. Alcoholism 

Treatment Quarterly, 27, 305–316. 

14 Voss, C. P., Cesar, K. W., Tymus, T., & Fiedler, I. G. (2002). 

Perceived versus actual physical accessibility of substance 

abuse treatment facilities. Topics in Spinal Cord Injury 

Rehabilitation, 7(3), 47–55. 
In Brief

Substance Use Disorders in People With Physical 

and Sensory Disabilities

15 Koch, D. S., Shearer, B., & Nelpovich, M. (2004). Service 

delivery for persons with blindness or visual impairment 

and addiction as coexisting disabilities: Implications for 

addiction science education. Journal of Teaching in the 

Addictions, 3(1), 21–48.

16 Titus, J. C., & Guthmann, D. (2010). Addressing the black hole 

in substance abuse treatment for Deaf and hard of hearing 

individuals: Technology to the rescue. Journal of the 

American Deafness and Rehabilitation Association, 43(2), 

92–100.

17 Substance Abuse and Mental Health Services Administration. 

(2010). Overview of Opioid Treatment Programs Within the

United States. Rockville, MD: Author. Retrieved June 3, 

2011, from http://www.oas.samhsa.gov/2k10/222/

222USOTP2k10.htm 

18 Moore, D., Guthmann, D., Rogers, N., Fraker, S., & Embree, 

J. (2009). E-therapy as a means for addressing barriers to 

substance use disorder treatment for persons who are Deaf. 

Journal of Sociology & Social Welfare, 36(4), 75–92.

In Brief 

This In Brief was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) by the 

Knowledge Application Program (KAP), a Joint Venture of The CDM Group, Inc., and JBS International, Inc., under contract 

number 270-09-0307, with SAMHSA, U.S. Department of Health and Human Services (HHS). Christina Currier served as 

the Government Project Officer. 

Disclaimer: The views, opinions, and content expressed herein do not necessarily reflect the views or policies of SAMHSA 

or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for particular instruments, 

software, or resources is intended or should be inferred.

Public Domain Notice: All materials appearing in this document except those taken from copyrighted sources are in the 

public domain and may be reproduced or copied without permission from SAMHSA or the authors. Citation of the source 

is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written 

authorization of the Office of Communications, SAMHSA, HHS. 

Electronic Access and Copies of Publication: This publication may be ordered from SAMHSA’s Publications Ordering 

Web page at http://www.store.samhsa.gov/home. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727). The 

document can be downloaded from the KAP Web site at http://www.kap.samhsa.gov. 

Recommended Citation: Substance Abuse and Mental Health Services Administration. (2011). Substance Use Disorders in 

People With Physical and Sensory Disabilities. In Brief, Volume 6, Issue 1.

HHS Publication No. (SMA) 11-4648 

Printed 2011