Substance use screening, brief intervention, and treatment among people with disabilities, National Survey of Drug Use and Health 2021-2023.

Abstract

People with disabilities report disproportionately high substance use. Screening, brief intervention, and receiving treatment are recommended to reduce harm. This study describes disability-related disparities in receiving screening, brief intervention, and treatment for tobacco, alcohol, and drugs. The 2021-2023 National Survey on Drug Use and Health (NSDUH) was used to estimate prevalence of screening, brief intervention, and receiving treatment for tobacco, alcohol, and illicit drug use among people with any disability and within six disability domains (cognitive, communication, hearing, mobility, self-care, vision). Disability was identified for those self-reporting "a lot of difficulty" or "cannot do at all" for the disability question in a particular domain. Screening was assessed among the full sample, whereas brief intervention and treatment were limited to those with current use and an identified substance use disorder. Logistic regression models examined associations between the outcomes and disability, adjusting for sociodemographic, healthcare utilization, and substance use variables. Adults with any disability had increased odds of receiving brief interventions for tobacco (aOR=1.21; CI: 1.01-1.44) and drugs (aOR = 1.25; CI: 1.06-1.48), then those without disabilities. Compared to those without the respective disability, adults with communication disabilities had lower odds of receiving tobacco (aOR=0.77; CI: 0.60-0.98) and alcohol screening (aOR=0.73; CI: 0.57-0.93), and those with visual disabilities had lower odds of receiving tobacco (aOR=0.80; CI: 0.68-0.95) and drug use screening (aOR=0.79; CI: 0.67-0.92). Adults with any disability (aOR=1.45; CI: 1.04-2.02), cognitive disabilities (aOR=1.70; CI: 1.14-2.53), and hearing disabilities (aOR=2.88; CI: 1.44-5.73) had higher odds of receiving drug use treatment, compared to those without respective disabilities. There are disparities in receiving components of screening, brief intervention, and treatment by disability domains. Continued disparities in substance use among those with disabilities may indicate the need for improved accessibility and tailored interventions.