ArticleJournal of substance use and addiction treatment2026
Intersecting challenges: Substance use and mental health disparities across self-reported disability status.
Article in Journal of substance use and addiction treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSubstance use and substance use disorders (SUD) disproportionately affect people with disabilities (PWD), yet PWD remain under-represented in addiction treatment literature. While recent work has begun to address SUD prevalence and recovery service gaps, little is known about how disability status shapes substance use outcomes. The present study is the first to our knowledge to investigate how recovery, mental health comorbidities, and barriers to care differ across disability status using structured survey data from people who use substances.
methods333 participants who use substances and provided information about their disability status in the baseline survey for a digital intervention study were included in the analysis (Mean
resultsOf the participants, 34.2 % reported having a disability (n = 114). PWD were more likely to be of color, unemployed, insured, and older, compared to those without disabilities (n = 219; ps ≤0.001). Regression analyses indicated that PWD had significantly higher odds of using cannabis, alcohol, stimulants, and other drugs over past 30-day (aORs ranged 2.22-2.30). PWD also had higher odds of endorsing depression, anxiety, and lifetime suicide attempts (aORs ranged from 2.39 (anxiety) to 3.38 (depression)). Additionally, PWD perceived more barriers to substance use treatment (β: 0.55 (0.24)) and reported more overdoses (aOR (95 % CI): 2.60 (1.49, 4.54)) and prior recovery attempts (aOR: 2.69 (1.55, 4.68)), compared to those without disabilities.
conclusionsThis study is among the first to use quantitative survey data to assess and compare substance use and treatment engagement among PWD and their non-disabled peers. Findings underscore urgent equity gaps in SUD treatment systems and the importance of incorporating disability-informed frameworks in clinical assessments and recovery services. These insights complement recent qualitative findings and emphasize the need for inclusive, accessible, and person-centered care approaches in substance use health services and research.
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