Drug and alcohol addiction is a chronic, but treatable condition that affects millions of individuals and families in the United States, including people with paralysis.

Multiple research studies show that people with physical disabilities that cause paralysis are more likely than the general population to develop a substance use problem. Research shows that people with disabilities are two to four times more likely to develop a substance use disorder compared to the general population. Those with spinal cord and traumatic brain injuries, in particular, are at a significantly higher risk of developing substance use disorders compared to the general population.

How Substance Use Treatment Could Help People Affected By Paralysis

Millions of people in the United States could benefit from substance use treatment, according to the Substance Abuse and Mental Health Services Administration. Yet only a small percentage actually receive treatment in any given year. People with physical disabilities, including those that cause paralysis, are even less likely than the general population to receive adequate, accessible addiction treatment.

What Is The Scope Of Paralysis?

Nearly one in five Americans, or about 60 million people, live with some form of paralysis.

Paralysis can be temporary or permanent. It can be localized to one area of the body such as the hands, feet, or face, or generalized, where multiple areas might be affected.

Generalized paralysis can be classified as:

diplegia: affecting corresponding areas on both sides of the body (e.g. both arms)
hemiplegia: affecting one side of the body
monoplegia: affecting only one limb
paraplegia: affecting the legs and lower body
quadriplegia: affecting both arms, legs, and sometimes the entire front from the neck down

Paralysis doesn’t look the same in everyone, and it can affect people in different ways. It can be temporary or permanent, and can be caused by a variety of conditions and injuries.

What Causes Paralysis?

Paralysis is a complete or partial loss of muscle function that can occur as a result of a birth defect, medical condition, or injury that affects how the muscles and nerves function.

Causes of paralysis include:

stroke
spinal cord injury
head injury
multiple sclerosis (MS)
spina bifida
cerebral palsy
exposure to toxins
Guillain-Barré syndrome
ALS (Lou Gehrig’s disease)
peripheral neuropathy

According to the Centers for Disease Control and Prevention (CDC), the leading causes of paralysis among Americans are stroke and spinal cord injury.

The Link Between Substance Abuse And Paralysis

Substance abuse is a term used to refer to the misuse of drugs or alcohol. This includes illicit drugs like cocaine, or prescription drugs like OxyContin or Xanax. A substance use disorder is a mental health disorder characterized by physical drug dependence or an inability to control one’s drug use or drinking. This is often referred to as addiction.

Some people are believed to be at a higher risk of developing drug and alcohol use issues, at no fault of their own but more likely due to genetic, environmental, and other personal factors.

High-risk groups among people with paralysis include:

young adults
veterans
people with co-occurring mental illness

Substance abuse can often develop as a response to difficulties experienced by people with disabilities, such as loneliness, chronic pain, depression, and thoughts of suicide. In the absence of supportive coping skills, drugs and alcohol may be used to numb, distract, or to self-medicate symptoms of a physical disability. Substances can also be used to explicitly cause injury to oneself.

What Puts People With Paralysis At Higher Risk For Substance Abuse?

Substance misuse typically can’t be traced back to a single cause. More often than not, it’s a variety of factors that can trigger harmful drinking habits or drug use. While genes, your environment, and personal factors can influence a person’s risk for substance misuse in the general population, people with paralysis can have additional risk factors.

Prescription Drug Use

Prescription painkillers and other powerful medications are often prescribed for people with paralysis. Unfortunately, these drugs are habit-forming and can be misused even by those who originally take them as prescribed.

Mental Health

Many people with physical disabilities are battling depression, anxiety, or live with post-traumatic stress disorder. These disorders can increase a person’s risk for substance abuse, particularly within disability communities.

Discrimination

Discrimination from others can play a role in substance misuse, particularly illicit drug use, among people with disabilities.

Stress

People with physical disabilities, including paralysis, experience unique sources of interpersonal, financial, and health-related stress. This can increase a person’s risk for turning to drugs or alcohol to cope.

Veteran Status

An estimated 42,000 people with spinal cord injuries in the United States are veterans. Veterans are at increased risk for substance misuse, mental health disorders, and suicide.

Feeling Disconnected

Many people with physical disabilities such as paralysis feel disconnected from others around them, or can be at greater risk for social isolation. Feeling isolated from others can increase the likelihood of heavy alcohol use or drug use to cope with loneliness.

What Are Common Drugs Of Abuse Among People With Paralysis?

Prescription drug misuse and alcohol misuse is very common among people with spinal cord injuries, and those paralyzed as a result of other causes.

Common drugs of abuse include:

alcohol
opioids (e.g. oxycodone, hydrocodone, tramadol)
heroin
cocaine
amphetamines (e.g. Adderall)

Polysubstance abuse, or the abuse of multiple drugs, is also common. This may include the concurrent use of prescribed medications, illicit drugs, and alcohol.

Can Substance Abuse Cause Paralysis?

According to the National Institute on Drug Abuse (NIDA), a wide range of commonly misused substances can have neurological effects when abused chronically or in excessive amounts.

Drugs that can cause neurological problems include:

cocaine
heroin
inhalants
hallucinogens (e.g. LSD, GHB)
methamphetamine
marijuana
prescription painkillers
prescription sedatives
salvia
tobacco

Over time, the chronic misuse of these drugs can have serious effects, including brain damage, seizures, and stroke, a leading cause of paralysis. According to an article published in the journal Brain and Behavior, drug use is one of the most common predisposing conditions for stroke among people under the age of 35.

Drug Overdose, Intoxication, And Paralysis

Drug overdose and intoxication can both affect the body’s muscles and nerves. Severe overdose, for instance, can cause strokes, seizures, and permanent injury to the brain and nerves. Intoxication from drugs and alcohol can also cause paralysis. Heavy drinking and drug use is a known risk factor for falls, accidental injuries, and motor vehicle accidents that can cause head and spinal cord injury.

Rates Of Substance Abuse And Paralysis In The U.S.

Substance abuse rates are significantly higher among people with paralysis, particularly those with spinal cord injuries (SCI), compared to the general population. Research shows that 50 to 90 percent of people with SCI use alcohol, and up to 50 percent are faced with substance abuse issues. The risk of developing addiction is dramatically elevated for this population, with individuals with SCI facing approximately four times the risk for alcohol addiction, seven to eight times the risk for cannabis addiction, and eight times the risk for opioid addiction compared to people without spinal cord injuries.

Key Statistics And Findings:

Alcohol and Drugs at Injury: Between 31 and 50 percent of individuals with SCI were intoxicated with alcohol at the time of their injury, and 16 to 33 percent were under the influence of drugs when the injury occurred.
Post-Injury Prevalence: Roughly 50 to 90 percent of people with SCI use alcohol after their injury, while 16 to 26 percent report using marijuana following their spinal cord injury.
Substance Use Disorder (SUD) Odds: Compared to people without SCI, those with spinal cord injuries have significantly higher risks for substance use disorders: nicotine (4.66 times higher), alcohol (4.19 times higher), cannabis (7.83 times higher), and opioids (7.97 times higher).
Opioid Use: While self-reported opioid use appears lower in some surveys, pooled research studies suggest the actual prevalence of opioid use in adults with SCI can be as high as 68 percent.
Types of Substances: Among individuals with chronic paralysis, cannabis is the most frequently used substance at 16.4 percent, followed by sedatives at 8.0 percent.
Traumatic Brain Injury (TBI): People who drink alcohol are at four times the risk of sustaining a traumatic brain injury, and up to 75 percent of TBIs occur while a person is intoxicated.
Young Adults With Spina Bifida: Young adults who have co-occurring spina bifida and depression show higher rates of alcohol use compared to their peers without these conditions.

These statistics highlight the urgent need for accessible, specialized addiction treatment for people living with paralysis and spinal cord injuries.

Addiction Treatment For People With Paralysis

Recovery from addiction is a lifelong process that often begins with intensive treatment, such as an inpatient rehab program or intensive outpatient. Drug and alcohol addiction can have serious physical, emotional, and psychological effects.

Addiction treatment may involve:

detoxification
individual and group counseling
family therapy
behavioral therapy
mental health counseling
medication assisted treatment
pain management assistance
relapse prevention

Healing from this takes time and can require treatment at multiple levels of care, depending on a person’s history of substance use, their health status, and other personal needs.

Making Treatment More Accessible

Under the Americans with Disabilities Act (ADA), all healthcare providers are required to ensure treatment is accessible for people with disabilities. Unfortunately, this isn’t a reality for all of those with disabilities who seek substance use treatment. Many treatment facilities are not fully accessible, according to the SAMHSA.

Addiction treatment providers can address:

Physical barriers: Rehab centers can ensure there aren’t architectural barriers that make it difficult for people with paralysis to navigate their physical property.
Staff training: Treatment providers can enlist the services of advocacy organizations to train staff on best treatment practices for people with paralysis.
Accessibility: Adapting treatment methods and services to accessible formats for people with paralysis can ensure they’re not excluded from any part of the treatment process.
Screening: Vocational rehabilitation (VR) counselors and other healthcare professionals can learn how to better screen for signs of substance misuse in people with paralysis.

Making substance use treatment accessible for everyone, including people with paralysis, is possible.

Barriers To Treatment For People With Paralysis

People with paralysis face unique obstacles when trying to access addiction treatment beyond just physical accessibility. Transportation is a major challenge, as many cannot drive themselves and rely on accessible transportation services that may be limited or expensive. The cost of treatment can be prohibitive for those already dealing with high medical expenses related to disability care and adaptive equipment.

Stigma presents another significant barrier, as people with paralysis may face judgment both for having a disability and for struggling with substance abuse. Some fear being labeled “non-compliant” or worry that seeking addiction treatment will affect their access to necessary pain medications. Many treatment facilities also lack staff trained in working with people who have physical disabilities, and may not be able to accommodate medical needs like catheter care, pressure sore prevention, or assistance with other activities.

Addiction And Paralysis Resources For Individuals And Families

Addiction can affect anyone, regardless of one’s physical abilities. If you or a loved one with paralysis is misusing drugs to self-medicate pain, depression, or stress, here is a list of resources.

General resources:

Christopher and Dana Reeve Foundation

This nonprofit organization is dedicated to curing spinal cord injury and improving the quality of life of those affected by spinal cord injuries.