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Addiction Treatment For Individuals With Disabilities: Rehab Centers For The Deaf And Blind

Jennifer Cousineau MSCP, LPCI, NCC

Medically reviewed by

Jennifer Cousineau, MSCP, LPCI, NCC

February 11, 2019

For those with a sensory disability, such as being deaf, hard of hearing, blind, or visually impaired, overcoming an addiction on top of attempting to find a treatment program that recognizes their needs just for daily life can be a daunting experience. This unfortunate truth presents a whole other set of challenges than just reaching sobriety.

Addiction can be a harrowing experience for anyone. For those with a sensory disability, such as a deaf, hard of hearing, blind, or visually impaired individual, this experience can be even more daunting. These individuals are faced with not only overcoming an addiction, but attempting to find a treatment program that recognizes, respects, and caters to their unique needs and challenges.

Though research is mixed on the subject—with some finding individuals with disabilities experiencing higher rates of substance use disorders and others documenting lower instances—what is certain, is that every person, regardless of a disability, must have access to effective evidenced-based treatment, in order to obtain a drug-free life.

For individuals with these sensory disabilities, each day may present unique obstacles and emotions that can make recovery difficult. In order to overcome these things, a person requires treatment from a drug rehab program that offers them the level of comprehensive and individualized support, treatment, and care that non-disabled individuals receive.

Unfortunately, the prevalence of these programs is less than the number that exists for non-disabled individuals, presenting even further hurdles these individuals have to overcome.

In order to help you achieve this, we’ve assembled critical information on this subject, that way you can make the best, and most informed, decision for yourself or your loved one.

Within this guide, you’ll find information on specific risk factors for this population, the dangers of substance use disorders (SUD), important elements and access points within treatment, and resources to help you find a program to best serve your needs.

These Issues May Start In Childhood

Overall, for disabled and non-disabled individuals alike, for many, their adult SUDs may be tied to experiences or elements within their childhood. However, for these populations there are certain facets of their childhood experience that are unique, or inexplicably tied to their disorders.

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As children, deaf, hard of hearing, blind, or visually impaired individuals often struggle to learn the full spectrum of information relating to the seriousness and effects of substance abuse, when these subjects are taught in school or other groups. Thus, as adults, they are not as well-versed in the risks, dangers, information, and coping skills that can be so pertinent when faced with substance use and abuse as a youth, teenager, or adult.

Secondly, these children may lack an ample and engaging support system at home, setting a poor foundation that may make them even more susceptible to substance abuse down the road. For example, the Institute for Research, Education & Training in Addiction (IRETA) writes:

“Deaf children whose families do not learn to communicate with them are four times more likely to suffer from mental health disorders than those whose families communicate well with them.”

We can infer then, that blind or vision impaired individuals may face the same challenges and effects. Research is definitive on the fact that mental health disorders put a person at an increased risk of developing a co-occurring substance use disorder.

Lastly, these children may face a variety of traumatic experiences at a young age, due to the insensitivity and discrimination they may often face in connection with their disability. These children are more apt to experience instances of bullying or cruelty, and research illustrates that they often see higher rates of neglect and abuse. Children who experience traumatic experiences, such as neglect and abuse face higher instances of substance use disorders later in life.

A Children’s Advocacy Center of North Carolina (with ‘d’ representing deaf and ‘hh’ hard of hearing) reports that:

  • nine percent of children without disabilities experience neglect
  • children with disabilities experience a rate of 31 percent, over three times that of children without
  • 10% of hearing boys and 25% of hearing girls experience sexual abuse
  • 54% of boys who are d/hh and 50% of girls who are d/hh report sexual abuse

Though foreign, we can still extract a beneficial perspective from a Norwegian study which documented that visually impaired children experienced the most severe form of sexual abuse in instances three times that of sighted children.

Are There Additional Risk Factors For Substance Abuse And Addiction?

Every person facing a substance use disorder developed it and continues to experience it in a way that is uniquely influenced by specific facets of their life, including their personal history, physical and mental health standing, and socioeconomic factors, among other things.

Combined, these elements may either increase their risk of developing an SUD or aid in the prevention. The Substance Abuse and Mental Health Services Administration’s (SAMHSA) “Substance Use Disorders in People With Physical and Sensory Disabilities,” outlines the following risk factors that individuals with disabilities may commonly face, some of which we’ve previously covered:

  • Pain or other chronic and debilitating medical condition
  • A means of obtaining prescription drugs, especially those for pain
  • Emotional or mental health issues, including depression
  • Experiencing a sense of isolation from society at large
  • Their caregivers, loved ones, or friends enable their drug or alcohol abuse
  • State of unemployment
  • Low level of education
  • Lower socioeconomic standing
  • Individual didn’t have proper preventative education on SUDs
  • Individuals experienced physical and/or sexual abuse

Individuals facing these situations may contend with a higher risk of an SUD. It is important to note, that having any one, or a combination of several, of these elements does not mean that a person will always develop an SUD.

How Do Substance Use Disorders Harm A Disabled Individual?

Substance abuse and addiction create a harmful and negative dynamic within anyone’s life, however, for those contending with a disability such as deafness, hearing loss, blindness, or impaired vision, there are certain ways that a SUD can create an environment that harms a person’s health and numerous aspects of their life. As cautioned by the aforementioned SAMHSA article, an active SUD may harm a disabled person in the following ways:

  • Person may not be able to become fully involved in rehab in a way that foster’s success
  • The drugs or alcohol may complicate the function of an existing medication (an interaction)
  • Reduced function of coordination and muscle movement
  • Impeded cognitive function
  • Decreasing the extent by which a person can take part in important measures of self-care
  • A person may become isolated, struggle to communicate, and experience stress at home
  • General state of poor mental and physical health; disorders or illnesses may arise which may also become disabling (such as depression or serious illness)
  • Struggle to achieve educational success
  • Detriment to other foundational elements, including a person’s job or living arrangements

The longer substance abuse or addiction remains unchecked, the more severe the damage may become.

For more information and other helpful resources to assist those who are deaf or hard of hearing visit the National Association Of The Deaf.

Factors To Consider For The Deaf

To fully understand the ways a deaf or hard of hearing person may struggle within treatment, and in turn, needs that must be met, we must pause to consider the ways that any treatment becomes effective. Therapy, counseling, and recovery support groups such as Alcoholics Anonymous are often primary components to drug rehab.

Without the proper assistance, these individuals may not be able to glean the full benefit from their sessions. With barriers in communication, a person could be inhibited from fully taking part in the discussions presented within both individual and group therapy sessions, effectively cutting them off from the candid and in-depth conversations between their therapists and peers that can be so vital to the recovery process.

While some programs may offer interpreters fluent in American Sign Language (ASL), it is rare that these conventional programs offer this assistance on a full-time basis.

Within rehab, many of the conversations outside of these more formal settings, such as those that occur over meals or recreational activities may be as beneficial towards the development of positive coping skills and acceptance, as more formal endeavors. Thus, an individual who does not have an interpreter at this time, or who isn’t adept at reading lips, may not be able to benefit from these forms of peer support and accountability.

While some programs may offer recorded versions of interpreted sessions, nothing compares to the dynamic of in-person interaction and the ability to ask questions. It is worth noting too, as explained by IRETA, that some individuals may not be able to read well, thus written literature may not fill this void.

This is because “ASL has its own syntax, its own idioms, and vocabulary for Deaf experience.” Due to these discrepancies, a deaf or hard of hearing individual may benefit more fully from a program that is especially designed for their needs.

Factors To Consider For The Blind

When on site at a treatment facility, a blind individual may struggle with ease of access to the facility’s various buildings. Beyond this, their treatment experience may be drastically inhibited as they may not be able to read any accompanying literature, including that which is offered in self-help groups, homework assignments, or as an accompaniment to therapy and/or counseling.

Many treatment programs may not offer these materials in a braille, audio format, or large print versions of the text. In addition, any films or visual aids that are integrated into various sessions will likely not be accessed by these individuals.

Because of the possibility of these issues, we urge you to thoroughly research all your options, while considering a program that is attentive and prepared to meet your needs.

Understanding The Influence Of The Americans With Disabilities Act

The Americans With Disabilities Act (ADA) of 1990 set forth a foundation of criteria, guidelines, and laws that seeks to protect all individuals with disabilities and provide them with equal access opportunities in all aspects of their life, by directing the responsibility to society as a whole. As excerpted from SAMHSA’s “Treatment Improvement Protocols,” “It is a comprehensive anti-discrimination law which extends to virtually all sectors of society and every aspect of daily living.” This includes substance abuse treatment.

Within the ADA, there are five titles, two of which are applicable to our purposes—Title II and Title III.

Title II: State and Local Government Services

The first title ensures that any state or local governmental programs or services, including substance abuse treatment programs, strictly adhere to policies and practicum that are nondiscriminatory in nature and provide full accessibility to programs, in their full capacity, to those with disabilities.

Title III: Public Accommodations

Title III requirements outline those which apply to “privately owned and operated programs that offer goods and services to the general public,” also including substance abuse treatment programs.

Again, individuals with disabilities cannot be discriminated against, and as per these guidelines, they must not be excluded from treatment or required to participate in a program other than what is offered to the public.

To do so, the ADA requires that “Reasonable modifications must be made to policies, practices, and procedures so that people with disabilities may participate.” Specifically, this dictates that “auxiliary aids and services” must be made available to ensure that disabled individuals are able to communicate their needs thoroughly and effectually, while receiving the appropriate information and services in the same manner.

Regarding substance abuse treatment, The Civil Rights Division of the U.S. Department of Justice has outlined the following factors that Title III providers must adhere to. These include:

  • Service must be rendered in a manner that allow all disabled individuals to obtain services in a nonsegregated environment. The only exception would be if an equal opportunity could not exist without alternative or separate accommodations.
  • Facilities must remove any criteria or guidelines for eligibility that prevent a disabled person from equally taking part in or benefiting from the treatment modalities, events, and resources offered by the treatment program.
  • A program must implement the necessary changes to the program’s policies and structural and procedural components that may prevent these individuals from obtaining equal access, “unless a fundamental alteration in the nature of the program would result.”
  • Provide access to auxiliary aids that assist these individuals in overcoming communication barriers, “unless an undue burden or fundamental alteration would result.”
  • Eliminate both “architectural and structural communication barriers” in facilities that are already built, if these changes are fairly obtainable.
  • If facility is unable to do so, they must grant individuals a different means of obtaining benefit from the program.
  • If the program provides transportation to client, they must have transportation that is accessible and equal for those with disabilities.
  • The facility must continuously ensure that its components are accessible.
  • If a new portion of the facility is being built or renovated, these portions must be created and constructed in a way that adheres to the Americans With Disabilities Act Accessibility Guidelines.

It is important to understand these guidelines, so that you may be aware of your rights as you’re seeking treatment. Even with these guidelines, many programs are not able to employ proper care and support for those with sensory disabilities, due largely to the burden these changes may make to their program.

Understanding The Components Of Comprehensive Treatment

When an individual has a necessity for drug or alcohol rehabilitation, they may most commonly choose either an outpatient or inpatient drug rehab. Though outpatient programs offer greater flexibility and access to therapy and counseling, they do not provide the intensive and individualized care that many addictions warrant.

Inpatient drug rehab allows an individual to reside on site, granting them continued access to a supportive and engaging staff during this time of need. One of the greatest benefits of inpatient drug rehab is a person is able to step away from their life, thus cutting off access to any temptation or cues that may induce cravings.

This can give a person the ability to better focus more fully on their recovery and can be a priceless benefit to a person with a sensory disability who may have suffered at the hand of, and even self-medicated, a sense of loneliness or isolation.

A good treatment program has various elements. Foremost, with certain drugs of abuse, a medically-assisted detox may be necessary to rid the body of the harmful toxins that chronic drug use caused to accumulate within their system. During, and after this time, various medications may be used, including those which are used within medication-assisted treatment (MAT)—a combination of medications and behavioral therapies.

In addition, you may have:

Reap The Full Benefit Of Your Treatment Experience

If you, or someone close to you, is struggling with deafness, hearing loss, blindness, or impaired vision, or any other disability, and is faced with an addiction, please reach out to our compassionate and expert staff at We can help you to further examine your options, from conventional, privately ran programs, to those that are tailored to fit the exact needs of your disability. Contact us today.

Institute for Research, Education & Training in Addiction - Substance use services for Deaf communities: What are the issues?

Substance Abuse and Mental Health Services Administration - Substance Use Disorders in People With Physical and Sensory Disabilities

SAMHSA’s Treatment Improvement Protocols - Appendix D—Alcohol and Drug Programs and The Americans With Disabilities Act

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