Substance abuse and psychosocial adaptation to physical disability: analysis of the literature and future directions

Purpose. To analyse the current state of the literature with respect to substance abuse and psychosocial adjustment in persons with disabilities. Method. The two primary databases containing the literature related to rehabilitation and disability issues (PsychINFO and MedLine) were searched to identify articles addressing the psychosocial impact of substance abuse in persons with disabilities. Eleven empirical articles specifically measuring the strength of the relationship between substance use and psychosocial outcomes in persons with disabilities were selected for analysis. Results. Of the studies identified, five were related to spinal cord injury, three were related to traumatic brain injury, one was related to chronic back pain, one was related to HIV/AIDS, and one was related to persons with any type of disability. Each of the studies used different methodologies, measured substance abuse in different ways, and examined different psychosocial outcome variables. Examination of trends suggested that pre-injury substance abuse appears to be unrelated to acceptance of disability in persons with spinal cord injury and negatively associated with satisfaction in persons with traumatic brain injury. Recent substance abuse tends to have a detrimental effect on psychosocial outcomes across all disability groups. Conclusions. Future research, combined with appropriate pre-service and continuing education related to substance abuse and disability for rehabilitation practitioners, has the potential to lead to improved psychosocial outcomes in persons with disabilities.