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Alcohol, Tobacco and Other Drugs After Disability: A Guide for Family Members

Choose a Path to a Healthier Lifestyle

Coping with a disability isn't easy. It can lead people to misuse alcohol, tobacco and other drugs and this can seriously hurt them. If your family member has a disability, you can help him or her make healthier choices. Here's some information that can help you.

Do you see your family member in any of these stories?

  • Sally is exhausted and depressed after a full day of rehabilitation. She takes the anti-seizure medicine her doctor prescribed – and then decides to have wine with dinner...
  • Alan’s job search is difficult and he’s worried. He’s eager to prove his disability won’t hold him back so he takes “uppers” for a boost...
  • Marcel is in pain. Several doctors prescribed painkillers, which he can take “as needed” for his injury. He starts taking several different drugs at once...
  • Tanya has had a hard day and is feeling down. So many things that used to be easy before her disability are now difficult. She turns on the T.V. and reaches for the first beer of the night...
  • Robert has been feeling lonely and upset since his accident, and he rarely leaves the house. To help him feel better, his mother buys him beer. Before the accident, she didn’t allow him to have alcohol in the house...
  • Russell uses everything he learned in rehabilitation to take better care of his body. However, he still keeps on smoking. He feels that he has a right to hang on to that, since everything else is so hard...

About the Issue

Many people with disabilities use alcohol, tobacco, and other drugs, often for the same reasons as people who do not have disabilities. However, there are also reasons related to disability which increase the pressure to drink, smoke, or take illicit drugs. They include:

  • Social isolation
  • The use of habit-forming medicines
  • Chronic pain
  • Too much free time
  • Feeling lonely and depressed
  • Wanting to fit in with friends
  • Supporting effort toward independence

If a family member with a disability uses alcohol, tobacco, or other drugs, he or she could have serious health problems as a result. For some people with disabilities, any use of alcohol or other drugs can be very dangerous. This happens because of the way the person’s body and mind react to the medicines they use. For example, some people who have nervous system disabilities can have seizures if they drink alcohol or other drugs.

What You and Your Family Can Do

  • Learn about alcohol, tobacco, and other drugs including the special risks associated with disability. You can read more, attend training sessions, talk to counselors or health educators, or attend disability-specific support groups.
  • Work with your family member’s rehabilitation specialist to:
    • Encourage your family member to take responsibility for his or her own behavior.
    • Provide your family member consistent feedback.
    • Help your family member deal with the feelings that lead him or her to use alcohol, tobacco, and other drugs.
  • Talk with your family member about what he or she will do when friends offer alcohol, tobacco, and other drugs to him or her.
  • Be a role model – cope with stress and other problems in a positive way. Demonstrate ways to have fun without drinking, smoking, or taking other drugs.
  • Ask one doctor to take responsibility for all medications to prevent your family member from misusing or abusing prescription medications. You may also need to help your family member take medications on schedule, to be sure they are used as the doctor intends.
  • Remove alcohol, tobacco, and other drugs from the house. Also, keep an eye on over-the-counter drugs and substances that could be inhaled.
  • Do not encourage use. Sometimes family members and friends may encourage people with disabilities to use alcohol, tobacco, or other drugs, believing it helps the person feel better. Encouraging the use of these substances (by buying or offering them to your family member) is called ‘enabling‘ because it helps them begin or continue substance abuse. While you should be flexible and understanding about disability-related limits, you should discourage unhealthy practices, such as the use of alcohol, tobacco, and other drugs
  • Don’t overlook this problem. Sometimes family members simply don’t notice the harmful effects of alcohol, tobacco, and other drugs because they are focusing so much on the disability. In fact, the problems created by these substances may be similar to problems created by the disability, so it is difficult to sort them out. Talk to a rehabilitation specialist about the differences.
  • Express your concerns in a caring but firm way. If you’re worried about possible substance abuse by a family member who has a disability, set boundaries. Define clear consequences in advance – consequences that are suitable for this particular situation, and that you’re really willing to carry out if needed.
  • Ask for help. If you identify a problem, explore some of the difficult actions that may be needed. Help your family member take charge of his or her life. You can talk with rehabilitation specialists and health educators, or attend support groups like Al-Anon (alcohol abuse) and Nar-Anon (drug abuse).

“Rehabilitation success requires commitment, energy, and determination... Rehabilitation requires sobriety.”

-James S. Jeffers, Director
Maryland Division of
Rehabilitation Services

Download PDF Version

Revised: 1/2015

This resource is provided as a courtesy of Craig Hospital. For more information, contact the Craig Hospital Nurse Advice Line at 1-800-247-0257.

Disclaimer: The content in this document is intended for general informational purposes only and is not a substitute for professional medical advice or treatment for specific medical conditions. No professional relationship is implied or otherwise established by reading this document. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Many of the resources references are not affiliated with Craig Hospital. Craig Hospital assumes no liability for any third party material or for any action or inaction taken as a result of any content or any suggestions made in this document and should not be relied upon without independent investigation. The information on this page is a public service provided by Craig Hospital and in no way represents a recommendation or endorsement by Craig Hospital.

This document was originally produced and published by the Resource Center on Substance Abuse Prevention and Disability and funded by the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention, Division of Public Education and Dissemination.