This article explores issues related to substance use disorders in persons with physical disabilities and the commonalities of the parallel research in recovery and adaptation to disability. An approach for converging these areas of research is presented. Parallel research in substance abuse counseling and rehabilitation counseling reveals that quality of life is an indicator of both adaptation to disability and recovery from substance use disorders. Despite this common outcome, the interaction of adapting to a disability and recovery from a substance use disorder has not been adequately addressed in the literature. A more integrative approach to counseling individuals with disabilities may be achieved with a better understanding of the complex relationship between quality of life, adaptation to disability, and substance use disorder. A converged approach to research is discussed in relation to the development of counseling interventions that improve the quality of life of persons with physical disabilities.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
2.
Bellack, A.S., & DiClemente, C.C. (1999). Treating substance abuse among patients with schizophrenia. Psychiatric Services, 50(1), 75-80.
3.
Betty Ford InstituteConsensus Panel. ( 2007). What is recovery? A working definition from the Betty Ford Institute. Journal of Substance Abuse Treatment, 33(3), 221-228.
4.
Bishop, M. ( 2005). Quality of life and psychosocial adaptation to chronic illness and disability: Preliminary analysis of a conceptual and theoretical synthesis. Rehabilitation Counseling Bulletin, 48(4), 219-231.
5.
Bishop, M., Chapin, M., & Miller, S.M. ( 2008). Quality of life assessment in the measurement of rehabilitation outcomes. Journal of Rehabilitation, 24, 45-54.
6.
Bombardier, C.H., & Rimmele, C.T. ( 1998). Alcohol use and readiness to change after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 79(11), 10-15.
7.
Bombardier, C.H., Rimmele, C.T., & Zintel, H. ( 2002). The magnitude and correlates of alcohol and drug use before traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 83(12), 1765-1773.
8.
Bombardier, C.H., Temkin, N.R., Machamer, J., & Dikmen, S.S. ( 2003). The natural history of drinking and alcohol-related problems after traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 84(2), 185-191.
9.
Boyle, P., & Weider, B. ( 2007). Creating and sustaining integrated dual diagnosis treatment programs: Some lessons learned in Ohio. Journal of Dual Diagnosis , 3(2), 103-110.
10.
Brown, A.L., & Saura, K.M. ( 1996). Vocational rehabilitation needs of individuals dually diagnosed with substance abuse and chronic mental illness. Journal of Applied Rehabilitation Counseling, 27(3), 3-10.
11.
Brucker, D.L. ( 2007). Substance abuse treatment participation and employment outcomes for public disability beneficiaries with substance use disorders . The Journal of Behavioral Health Services & Research , 34(3), 290-308.
12.
Bugard, J.F., Donohue, B., Azrin, N.H., & Teichner, G. ( 2000). Prevalence and treatment of substance abuse in the mentally retarded population: An empirical review. Journal of Psycho-active Drugs, 32(3), 293-298.
13.
Chapin, M.H., Miller, S.M., Ferrin, J.M., Chan, F., & Rubin, S.E. ( 2004). Psychometric validation of a subjective well-being measure for people with spinal cord injuries. Disability and Rehabilitation: An International, Multidisciplinary Journal, 26(19), 1135-1142.
14.
Corrigan, J.D. ( 1995). Substance abuse as a mediating factor in outcome from traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 76(4), 302-309.
15.
Corrigan, J.D., & Bogner, J. ( 2007). Interventions to promote retention in substance abuse treatment. Brain Injury, 21(4), 343-356.
16.
Cummins, R.A. ( 2005). Moving from the quality of life concept to a theory. Journal of Intellectual Disability Research, 49(10), 699-706.
17.
Devins, G.M. ( 1994). Illness intrusiveness and the psychosocial impact of lifestyle disruptions in chronic life-threatening disease. Advances in Renal Replacement Therapy, 1(3), 251-263.
18.
Dijkers, M. ( 1997). Measuring quality of life. In M. J. Fuhrer (Ed.), Assessing medical rehabilitation practices: The promise of outcomes research (pp. 153-180). Baltimore, MD: Paul H. Brooks.
19.
Drake, R.E., McHugo, G.J., Xie, H., Fox, M., Packard, J., & Helmstetter, B. (2006). Ten-year recovery outcomes for clients with co-occurring schizophrenia and substance use disorders. Schizophrenia Bulletin, 32(3), 464-473.
20.
Drake, R.E., Xie, H., McHugo, G.J., & Shumway, M. ( 2004). Three-year outcomes of long-term patients with co-occurring bipolar and substance use disorders. Biological Psychiatry , 56(10), 749-756.
21.
Drebing, C.E., Fleitas, R., Moore, A., Krebs, C., Van Ormer, A., Penk, W., et al. (2002). Patterns in work functioning and vocational rehabilitation associated with coexisting psychiatric and substance use disorders . Rehabilitation Counseling Bulletin, 46(1), 5-13.
22.
Elliott, T.R., Kurylo, M., Chen, Y., & Hicken, B. ( 2002). Alcohol abuse history and adjustment following spinal cord injury. Rehabilitation Psychology, 47, 278-290.
23.
Fabian, E.S. ( 1991). Using quality-of-life indicators in rehabilitation program evaluation. Rehabilitation Counseling Bulletin, 34(4), 344-356.
24.
Faces and Voices of Recovery. (2005). Commentary on "Defining and measuring recovery." Retrieved November 30, 2009, from http://www.facesandvoicesofrecovery.org/pdf/recovery_commentary_arndt_taylor.pdf
25.
Glenn, M.K., Ford, J., Moore, D., & Hollar, D. ( 2003). Employment issues as related by individuals living with HIV or AIDS. Journal of Rehabilitation, 69, 30-36.
26.
Hasin, D., Hatzenbuehler, M.L., Keyes, K., & Ogburn, E. ( 2006). Substance use disorders: Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV) and international classification of diseases, tenth edition (ICD-10). Addiction ( Abingdon, England), 101(Suppl. 1), 59-75.
27.
Heinemann, A.W. ( 1993). Prevalence and consequences of alcohol and other drug problems following spinal cord injury. In A. W. Heinemann (Ed.), Substance abuse and physical disability (pp. 63-113). New York: Haworth Press.
28.
Heinemann, A.W., Goranson, N., Ginsburg, K., & Schnoll, S. ( 1989). Alcohol use and activity patterns following spinal cord injury. Rehabilitation Psychology, 34(3), 191-205.
29.
Heinemann, A.W., & Hawkins, D. ( 1995). Substance abuse and medical complications following spinal cord injury. Rehabilitation Psychology, 40(2), 125-140.
30.
Heinemann, A.W., Lazowski, L.E., Moore, D., Miller, F., & McAweeney, M. ( 2008). Validation of a substance use disorder screening instrument for use in vocational rehabilitation settings. Rehabilitation Psychology, 53(1), 63-72.
31.
Heinemann, A.W., McAweeney, M., Lazowski, L.E., & Moore, D. ( 2008). Utilization of substance abuse screening by state vocational rehabilitation agencies. Journal of Applied Rehabilitation Counseling. Special Issue: Vocational Rehabilitation & Substance Use Disorders, 39(2), 5-11.
32.
Heinemann, A.W., McGraw, T.E., Brandt, M.J., Roth, E., Dell’Oliver, C., & Schnoll, S. ( 1992). Prescription medication misuse among persons with spinal cord injuries. International Journal of the Addictions, 27(3), 301-316.
33.
Hergenrather, K.C., & Rhodes, S.D. ( 2006). Consumers with a disability of substance abuse: Exploring beliefs impacting placement. Journal of Applied Rehabilitation Counseling, 37(3), 3-12.
34.
Hollar, D., McAweeney, M., & Moore, D. ( 2008). The relationship between substance use disorders and unsuccessful case closures in vocational rehabilitation agencies. Journal of Applied Rehabilitation Counseling, 39(3), 48-52.
35.
Horsfall, J., Cleary, M., Hunt, G.E., & Walter, G. ( 2009). Psychosocial treatments for people with co-occurring severe mental illness and substance use disorders: A review of the empirical evidence. Harvard Review of Psychiatry, 17(1), 24-34.
36.
Judd, L.L., & Akiskal, H.S. ( 2003). The prevalence and disability of bipolar spectrum disorders in the US population: Re-analysis of the ECA database taking into account sub-threshold cases. Journal of Affective Disorders. Special Issue: Validating the Bipolar Spectrum, 73(1-2), 123-131.
37.
Kennedy, P., Marsh, N., Lowe, R., Grey, N., Short, E., & Rogers, B. ( 2000). A longitudinal analysis of psychological impact and coping strategies following spinal cord injury. British Journal of Health Psychology, 5(Part 2), 157-172.
38.
Krahn, G., Deck, D., Gabriel, R., & Farrell, N. ( 2007). A population-based study on substance abuse treatment for adults with disabilities: Access, utilization, and treatment outcomes . American Journal of Drug and Alcohol Abuse, 33(6), 791-798.
39.
Krahn, G., Farrell, N., Gabriel, R., & Deck, D. ( 2006). Access barriers to substance abuse treatment for persons with disabilities: An exploratory study. Journal of Substance Abuse Treatment, 31(4), 375-384.
40.
Laudet, A.B. ( 2007). What does recovery mean to you? Lessons from the recovery experience for research and practice. Journal of Substance Abuse Treatment, 33(3), 243-256.
41.
Leukefeld, C.G., & Tims, F.M. ( 1989). Relapse and recovery in drug abuse: Research and practice . International Journal of the Addictions, 24(3), 189-201.
42.
Lewis, J.A., Dana, R.Q., & Blevins, G.A. ( 2002). Substance abuse counseling (3rd ed.). Pacific Grove, CA: Brooks/Cole .
43.
Li, L., & Moore, D. ( 1998). Acceptance of disability and its correlates. The Journal of Social Psychology, 138(1), 13-25.
44.
Little, J. ( 2001). Treatment of dual diagnosis. Journal of Psycho-active Drugs, 33(1), 27-31.
45.
Livneh, H. ( 1986). A unified approach to existing models of adaptation to disability: II. Intervention strategies. Journal of Applied Rehabilitation Counseling, 17(2), 6-10.
46.
Livneh, H. ( 2001). Psychosocial adaptation to chronic illness and disability: A conceptual framework. Rehabilitation Counseling Bulletin , 44(3), 151-160.
47.
Livneh, H. ( 2009a). Denial of chronic illness and disability: Part I. Theoretical, functional, and dynamic perspectives. Rehabilitation Counseling Bulletin, 52(4), 225-236.
48.
Livneh, H. ( 2009b). Denial of chronic illness and disability: Part II. Research findings, measurement considerations, and clinical aspects. Rehabilitation Counseling Bulletin, 53(1), 44-55.
49.
Livneh, H., & Antonak, R.F. ( 1997). Psychosocial adaptation to chronic illness and disability . Gaithersburg, MD: Aspen.
50.
Livneh, H., & Antonak, R.F. ( 2005). Psychosocial adaptation to chronic illness and disability: A primer for counselors. Journal of Counseling & Development , 83(1), 12-20.
51.
Mares, A.S., & Rosenheck, R.A. (2006). Attitudes towards employment and employment outcomes among homeless veterans with substance abuse and/or psychiatric problems. American Journal of Psychiatric Rehabilitation , 9(3), 145-166.
52.
Marlatt, G.A., & Baer, J.S. ( 1988). Addictive behaviors: Etiology and treatment. Annual Review of Psychology, 39, 223-252.
53.
Matto, H.C. ( 2004). Applying an ecological framework to understanding drug addiction and recovery. Journal of Social Work Practice in Addiction, 4(3), 5-22.
54.
McAweeney, M., Jones, M., & Moore, D. ( 2008). Employment barriers for persons with substance use disorders and co-occurring disabilities: Supported employment strategies. Journal of Applied Rehabilitation Counseling. Special Issue: Vocational Rehabilitation & Substance Use Disorders, 39(2), 19-24.
55.
McAweeney, M., Keferl, J., Moore, D., & Wagner, J. ( 2008). Predictors of successful closure in the state-federal vocational rehabilitation system: Findings from a sample of persons with disability and substance use disorders. Journal of Applied Rehabilitation Counseling. Special Issue: Vocational Rehabilitation & Substance Use Disorders , 39(2), 30-36.
56.
McGue, M., Slutske, W., Taylor, J., & Iacono, W.G. ( 1997). Personality and substance use disorders: I. Effects of gender and alcoholism subtype. Alcoholism: Clinical and Experimental Research, 21(3), 513-520.
57.
Miller, S.M., Chan, F., Ferrin, J.M., Lin, C.P., & Chan, J.C.Y. ( 2008). Confirmatory factor analysis of the World Health Organization Quality of Life Questionnaire-Brief Version for individuals with spinal cord injury. Rehabilitation Counseling Bulletin, 51(4), 221-228.
58.
Miller, W.R., & Rollnick, S. ( 1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford .
59.
Moore, D., & Li, L. ( 1994). Alcohol use and drinking-related consequences among consumers of disability services. Rehabilitation Counseling Bulletin. Special Issue: Drugs and Alcohol, 38(2), 124-133.
60.
Morgan, T.J., Morgenstern, J., Blanchard, K.A., Labouvie, E., & Bux, D.A. ( 2003). Health-related quality of life for adults participating in outpatient substance abuse treatment. The American Journal on Addictions, 12(3), 198-210.
61.
Murrey, G.J., Dallas, R., & Maki, A. ( 2007). History of reported head trauma in a sample of women in substance abuse treatment. American Journal of Drug and Alcohol Abuse, 33(2), 327-332.
62.
Prochaska, J.O., & DiClemente, C.C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory, Research & Practice, 19(3), 276-288.
63.
Richards, J.S., Kewman, D.G., & Pierce, C.A. ( 2000). Spinal cord injury. In R. G. Frank & T. R. Elliott (Eds.), Handbook of rehabilitation psychology (pp. 9-28). Washington, DC : American Psychological Association.
64.
Robinson, M., & Klein, M. ( 2008). Dual diagnosis: Does race affect vocational rehabilitation outcomes? Journal of Applied Rehabilitation Counseling, 39(3), 19-24.
65.
Roessler, R.T. ( 1990). A quality of life perspective on rehabilitation counseling . Rehabilitation Counseling Bulletin, 34(2), 82-90.
66.
Roessler, R., & Bolton, B. ( 1978). Psychosocial adjustment to disability. Baltimore, MD: University Park Press.
67.
Room, J.A. ( 1998). Work and identity in substance abuse recovery. Journal of Substance Abuse Treatment. Special Issue: The Social Model Approach to Substance Abuse Recovery, 15(1), 65-74.
Rudolf, H., & Watts, J. ( 2002). Quality of life in substance abuse and dependency. International Review of Psychiatry, 14(3), 190-197.
70.
Russell, M.R., Peirce, R.S., Chan, A.W.K., Wieczorek, W.F., Moscato, B.S., & Nochajski, T.H. (2001). Natural recovery in a community-based sample of alcoholics: Study design and descriptive data. Substance Use and Misuse, 36(11), 1417-1441.
71.
Schaar, I., & Ojehagen, A. ( 2003). Predictors of improvement in quality of life of severely mentally ill substance abusers during 18 months of co-operation between psychiatric and social services. Social Psychiatry and Psychiatric Epidemiology , 38(2), 83-87.
72.
Schwab, A.J., & DiNitto, D.M. ( 1993). Factors related to the successful vocational rehabilitation of substance abusers. Journal of Applied Rehabilitation Counseling , 24(3), 11-20.
73.
Sellman, J.D., Mulder, R.T., Sullivan, P.F., & Joyce, P.R. ( 1997). Low persistence predicts relapse in alcohol dependence following treatment. Journal of Studies on Alcohol, 58(3), 257-263.
74.
Smedema, S.M., Bakken, S.K., & Dalton, J. ( 2009). Psychosocial adaptation to chronic illness and disability: Models and measurement. In F. Chan, E. Cardoso, & J. Chronister (Eds.), Understanding psychosocial adjustment to chronic illness and disability: A handbook for evidence-based practitioners in rehabilitation (pp. 51-74). New York: Springer.
75.
Smedema, S.M., & Ebener, D.J. (in press). Substance abuse and psychosocial adaptation to physical disability: Analysis of the literature and future directions. Disability & Rehabilitation.
76.
Tate, D.G., Forchheimer, M.B., Krause, J.S., Meade, M.A., & Bombardier, C.H. (2004). Patterns of alcohol and substance use and abuse in persons with spinal cord injury: Risk factors and correlates. Archives of Physical Medicine and Rehabilitation , 85(11), 1837-1847.
77.
Taylor, L., Kreutzer, J., Demm, S., & Meade, M. ( 2003). Traumatic brain injury and substance abuse: A review and analysis of the literature. Neuropsychological Rehabilitation , 13, 165-188.
78.
The WHOQOL Group. (1995). The World Health Organization Quality of Life Assessment: Position paper from the World Health Organization. Social Science & Medicine , 41, 1403-1409.
79.
Turner, R.J., Lloyd, D.A., & Taylor, J. ( 2006). Physical disability and mental health: An epidemiology of psychiatric and substance disorders. Rehabilitation Psychology , 51(3), 214-223.
80.
U.S. Department of Health & Human Services, Office on Disability. (n.d.). Substance abuse and disability. Retrieved January 5, 2009, from http://www.hhs.gov/od/about/fact_sheets/substanceabuse.html
81.
Vash, C.V., & Crewe, N.M. ( 2004). Psychology of disability (2nd ed.). New York: Springer.
82.
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.
83.
West, S.L., Graham, C.W., & Cifu, D.X. ( 2009). Physical and programmatic accessibility of British alcohol/other drug treatment centers. Alcoholism Treatment Quarterly, 27(3), 294-304.
84.
West, S.L., Luck, R.S., & Capps, C.F. ( 2007). Physical inaccessibility negatively impacts the treatment participation of persons with disabilities. Addictive Behaviors , 32(7), 1494-1497.
85.
Westermeyer, J., Kemp, K., & Nugent, S. ( 1996). Substance disorder among persons with mild mental retardation: A comparative study. The American Journal on Addictions, 5(1), 23-31.
86.
World Health Organization. (2003). WHO definition of health. Retrieved November 30, 2009, from http://www.who.int/about/definition/en/print.html
