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DISABILITIES AND SUBSTANCE ABUSE

DISABILITIES AND SUBSTANCE ABUSE. DEFINING DISABILITY. A MENTAL OR PHYSICAL CONDITION THAT RESTRICTS THE INDIVIDUAL’S ABILITY TO ENGAGE IN SUBSTANTIAL GAINFUL ACTIVITY. HISTORICALLY AN OPPRESSED GROUP (SOCIETAL ATTITUDES). DEFINING.

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DISABILITIES AND SUBSTANCE ABUSE

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  1. DISABILITIES AND SUBSTANCE ABUSE

  2. DEFINING DISABILITY • A MENTAL OR PHYSICAL CONDITION THAT RESTRICTS THE INDIVIDUAL’S ABILITY TO ENGAGE IN SUBSTANTIAL GAINFUL ACTIVITY. • HISTORICALLY AN OPPRESSED GROUP (SOCIETAL ATTITUDES)

  3. DEFINING • DEFINITIONS HAVE HISTORICALLY INCLUDED MEDICAL INFLUENCES (DISEASE), ECONOMIC INFLUENCES (SSDI), AND FUNCTIONAL LIMITATIONS (WORK, LIVING INDEPENDENTLY).

  4. HISTORY OF SOCIAL POLICY • SOCIAL SECURITY (SSDI ACT OF 1956) • EDUCATION FOR ALL HANDICAPPED CHILDREN ACT OF 1975 (LEAST RESTRICTIVE EDUCATIONAL ENVIRONMENT FOR ALL CHILDREN; MAINSTREAMING)

  5. HISTORY OF POLICY • REHABILITATION ACT OF 1973 ( PROVIDING VOCATIONAL REHABILITATION FOR ADULTS WITH DISABILITIES IF EMPLOYMENT IS FEASIBLE) • AMERICAN WITH DISABILITIES ACT OF 1992 (SEE HANDOUT)

  6. Overview • 49 million Americans (difficult to count) • Numbers increasing • Types include: * psychiatric illness * cognitive developmental disability * blindness and visual impairment * deafness and hardness of hearing * learning disabilities * mobility limitations

  7. Overview • * spinal cord injuries * traumatic brain injury • Substance abuse has historically been ignored by clinicians • 15-30% have a substance abuse problem (49% of spinal cord injury; 62% of Vocational Rehabilitation clients;8-10% of deaf and hard of hearing)

  8. Risk Factors • Health and medical risk factors i.e. chronic pain and misuse of prescription drugs or alcohol • Psychological risk factors i.e. unhealthy coping with disability, stress with family • Social risk factors i.e. less support, more isolative, negative social attitudes • Economic risk factors i.e. unemployment or underemployment • Access-lack of accessible treatment (i.e. is an interpreter available for the deaf client)

  9. Treatment • Woefully lacking • Need for cross-trained staff (rehabilitation staff and substance abuse treatment staff) • Those individuals with related health, employment, financial, and legal problems are most at risk

  10. Treatment Should Include: • Individual counseling • Group counseling • Family counseling • Education • Support groups for both the substance abuse and disability

  11. Counseling Should Address: • Grief and loss issues as related to both the substance abuse and to the disability • Major life changes • Loss of privacy • Devaluing, enabling, and patronizing societal attitudes • Stress on the family • Education about how to manage the disability without the use of the substance

  12. Who gets AIDS? • No one is immune • Gay men and intravenous drugs users are at highrisk • Many drugs also suppress theimmune system (alcohol, opiates)

  13. Counseling the AIDS client • Reduce fear • Reduce shame • Educate them as to selfcare and safe sex • Be positive and hopeful • Touch is important

  14. Counseling the AIDS client • Keep values and judgments out of the treatment process • Help the client to change and sustain behavior

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