Academic journal article The Journal of Rehabilitation

Substance Use among Applicants for Vocational Rehabilitation Services

Academic journal article The Journal of Rehabilitation

Substance Use among Applicants for Vocational Rehabilitation Services

Article excerpt

Recent clinical and research findings have clearly demonstrated that the presence of a physical, mental, or psychological disability can place an individual at greater risk for problems associated with substance abuse (Buss & Cramer, 1989; de Miranda & Cherry, 1989; Moore & Siegal, 1989; Moore, 1991). Despite the fact that persons with disabilities experience disability-specific and more common risks for substance abuse, little has been known of the patterns of alcohol and drag use among people with disabilities and the associated risk factors.

There is little doubt that substance abuse by consumers of rehabilitation services interferes with their success in these systems. It has been postulated that untreated substance abuse as a co-existing disability eventually will lead to medical problems or other barriers to a fully functional life. "In their collective wisdom, rehabilitation counselors have recognized that a significant portion of the persons whom they serve have two or more disabilities. The first disability, the mason they were referred, was often recognized as a physical or mental disability. It is usually easily diagnosed with common functional limitations. The second disability, substance abuse, is rarely mentioned and often recognized late in the rehabilitation process." (Corthell and Brown, 1991, p. ix.)

Substance abuse can either precede or follow the onset of another disability (Glass, 1980/81), but often it leads to the acquisition of other disabilities. For example, subacute head injuries may be a common by-product of a lifestyle that includes drug abuse (Alterman and Tarter, 1985). When substance abuse is present there are more likely to be additional risk factors as well. The risks include limited social resources, low socioeconomic conditions, and multiple disability status, all of which reduce the likelihood of successful vocational rehabilitation (Heinemann, McGraw, Brandt, Roth, & Dell'Oliver, 1990; Ford & Moore, 1992; Renwick & Krywonis, 1992). Nevertheless, there have been few previous studies addressing substance abuse problems in rehabilitation settings, and consequently little is known of rehabilitation procedures with individuals who experience both chemical dependency and a concomitant disability.

In 1990, the SARDI (Substance Abuse Resource and Disability Issues) project was funded by the Center for Substance Abuse Prevention (CSAP) to address issues of substance abuse and disability among a variety of professionals, including those working in rehabilitation settings. This five state regional pilot was conducted in Illinois, Indiana, Kentucky, Michigan, and Ohio. During the two-year period of primary study, 30 agencies and organizations such as university disability offices, vocational and medical rehabilitation programs, community mental health agencies, and other specialized disability services contributed to an extensive evaluation data base.

The purpose of this article is to illustrate the findings from the survey of alcohol, other drug, and medication use conducted within Michigan Rehabilitation Services (MRS), one of the SARDI service and research sites. More specifically, prevalence and distributions of substance use among rehabilitation applicants, as well as their disability conditions, attitudes toward substance use among people with disabilities, and demographic background are described. In addition, primary relationships among the variables of interest are examined.



The respondents in this study were individuals with disabilities who were seeking vocational rehabilitation services at a number of field offices for Michigan Rehabilitation Service (MRS). A total of 246 respondents within the MRS system completed the survey questionnaires. The 19 respondents who claimed to have chemical dependency as a primary disability (7.7%) were excluded from data analysis in order to focus exclusively on substance use among people with other disabilities. …

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