Addiction Recovery In The Deaf And Hard-Of-Hearing Communities

Medically Reviewed by Johnelle Smith, M.D. on April 19, 2021

Substance abuse in the deaf community is rarely highlighted in mainstream discussions about addiction, despite the unique risk factors they face. Here, you’ll find information about substance abuse in the deaf and hard-of-hearing communities and treatment options.

Addiction Recovery For The Deaf And Hearing-Impaired

Substance abuse and addiction affect more than 20 million people in the United States. Nearly five million Americans are believed to have a co-occurring disability.

In recent decades, greater light has been shed on the prevalence of substance use in deaf and hard-of-hearing communities, due to increased research and the advocacy of those affected.

Substance use disorders can develop in anyone, regardless of physical and mental health status. Yet, too often, these disorders are underdiagnosed or misdiagnosed in people with sensory disabilities.

Here, you’ll find:

  • Information on substance use in the deaf community
  • Risk factors for developing substance use disorders
  • Available addiction treatment options
  • Resources for individuals and families affected by addiction and hearing loss

What Does It Mean To Be Hard-Of-Hearing?

Hard-of-hearing is a term used to describe a range of experiences with hearing loss. This is more inclusive than the term ‘deafness’ which refers specifically to the full or near-full loss of hearing.

Hard-of-hearing communities are diverse. Some people have partial or full hearing loss. Some are born with a degree of hearing loss, while others lose their hearing as a result of injury, illness, or age.

Different terms used within the hearing-impaired and deaf communities:

  • Deafness refers to full hearing loss, or very little functioning hearing.
  • Hard-of-hearing is a term used to describe mild to moderate hearing loss. People who are hard-of-hearing may or may not choose to use a hearing aid to assist with communication.
  • Late deafened describes people who previously had full hearing, but lost some of all of their functioning hearing due to injury, illness, or age.
  • Hearing community is a term used by some to describe people who do not have hearing loss—that is, those with fully functional hearing.
  • D/HH community is an inclusive term used by some advocates to describe populations who are either deaf or hard-of-hearing.

There are several ways to identify different types of hearing loss. Hearing loss can affect different parts of the ear, which may affect the extent to which it affects functional hearing.

What We Know About Substance Abuse And Hearing Impairment

According to the Hearing Loss Association of America, about 48 million people in America have some form of hearing loss.

No one, including those with a physical disability, are immune from developing a substance use disorder.

What research shows is that people with a physical or mental disability are likely to be at a higher risk of abusing drugs or alcohol than those without.

What research shows about substance abuse and hearing impairment:

  • People under the age of 25 with hearing loss are up to 2.5 times more likely to misuse prescription drugs compared to peers without hearing loss.
  • Rates of substance abuse within the D/HH community are at least as high as rates within the hearing community.
  • People with a physical disability are at two to four times the risk of having a substance use disorder.
  • People with hearing loss more often report heavy alcohol or marijuana use compared to the hearing community.
  • Hearing loss is associated with a higher risk of prescription opioid misuse among adults aged 18 to 34.
  • Some of the most common drugs of abuse among hearing-impaired individuals are alcohol, prescription painkillers, heroin, cocaine, and marijuana.
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Why Is Substance Abuse So Common In The Deaf Community?

Generally, the underlying causes of substance abuse and addiction are complex. This is true for the general population, as well as people who are deaf or hard-of-hearing.

Within the hard-of-hearing community, there are several factors related to communication barriers and environmental conditions that can increase the risk of substance abuse.

Risk factors specific to the deaf and hard-of-hearing community include:

  • difficulty communicating with others
  • reduced exposure to drug and alcohol education
  • chronic medical difficulties
  • experiencing discrimination
  • isolation from others
  • low socioeconomic level
  • lack of access to treatment services and resources
  • higher rates of unemployment and homelessness

Why a person turns to drugs or alcohol is unique to the person. There are many personal, genetic, and environmental factors that can influence a person’s drinking or drug habits.

Generally, a person is more likely to develop an addiction if they have a family history of substance abuse, have experienced trauma, or have a co-occurring mental illness.

Social and economic conditions, too—such as poverty, housing, being insured, and having a social support system—can also affect a person’s risk for developing a substance use disorder.

Can Substance Abuse Cause Hearing Impairment?

There’s some evidence that the chronic, heavy use of certain drugs can cause changes in sensory perception, including auditory and visual changes.

Types of drug abuse that can potentially impair hearing:

  • opioid abuse
  • acetaminophen abuse
  • Aspirin abuse

Certain drugs, even when not misused, can also affect hearing.

According to the University of Michigan Health System, this includes some medicines used to treat cancer, high blood pressure, and heart failure.

What Are The Dangers Of Drug And Alcohol Abuse?

Substance abuse can have many harmful and potentially life-threatening effects in the short-term and over time.

Some of the primary dangers include the risk of drug dependence, addiction, and overdose.


About 130 people in the U.S. die from a drug overdose each day. In 2019, an estimated 70,630 people died due to a fatal drug overdose, largely involving illicit forms of fentanyl and psychostimulants like meth and cocaine.

Physical Health Problems

Drug and alcohol abuse can increase the risk of developing certain cancers, cause organ damage, and may negatively affect vision and hearing (with certain drugs).

Mental Health

Chronic substance abuse may cause a person to become more anxious, depressed, and agitated—either due to the effects of the drugs, or the stress of having a substance use disorder.

Risk Of Suicide

Substance abuse can increase the risk of suicidal thoughts and suicide attempts, in part due to the effects of drugs and alcohol on the brain.

Social And Economic Costs

Drug and alcohol abuse can have harmful effects on relationships, employment status, and increase the risk of legal problems, high medical costs, and housing instability among those without housing assistance.

Drug Addiction Treatment For The Deaf And Hard-Of-Hearing

Drug and alcohol addiction treatment options are more limited for people with sensory disabilities compared to the general population—but they do exist.

Generally, people who are addicted to drugs or alcohol need treatment at multiple levels of care to help them heal from the physical, emotional, and psychological effects of substance abuse.

Treatment programs for substance abuse include:

  • inpatient detox
  • residential treatment
  • partial hospitalization programs
  • intensive outpatient programs
  • general outpatient programs

Substance abuse rehabilitation programs may staff American Sign Language (ASL) interpreters to assist people with deafness or hard-of-hearing during the treatment process.

Addiction treatment centers may be able to offer personalized assistance for individuals and families to ensure the individual has access to the support services they need within a treatment program.

What Are The Barriers To Addiction Treatment?

Despite the existence of substance use disorders in the deaf community, not all rehab centers in the U.S. offer the level of accommodation people with hearing loss may need.

Common barriers include:

  • Making the call: For some with hearing loss, even making an initial phone call to a treatment center can be difficult. For this, treatment providers are encouraged to train admissions staff to use a TTY option.
  • Reduced rehab options: Treatment centers may not offer 24-hour support for people with hearing loss, which can limit the level of care they are able to receive.
  • Budget: Treatment providers may fail to budget for accommodations, such as 24-hour accessible support services.
  • Inaccessibility: Treatment centers may lack ASL interpreters who are licensed to treat addiction.
  • Cost: Cost is a major barrier to treatment for all people with substance use disorders, but especially those who are low-income, houseless, or have health insurance not accepted by a rehab center.

Are Addiction Rehab Centers Required To Provide Accommodation?

Technically, yes. Under the Americans with Disabilities Act (ADA), mental healthcare providers are required to provide effective communications for people who are deaf or hard-of-hearing.

Under the ADA and other laws, you have the right to:

  • Communicate with a health professional in a safe and confidential environment
  • Get a clear understanding of your diagnosis and the recommendations for your treatment
  • Clearly understand any medications you are being asked to take, and what the side effects of those medications are
  • Ask for a referral from your insurance company or a social service agency to be connected with a qualified treatment professional with experience treating people with hearing loss

Some states have also passed their own Mental Health for Deaf and Hard of Hearing Individual Bill of Rights, which offers additional protections, according to the National Association for the Deaf.

People who wish to report ADA violations at a treatment center can contact the Civil Rights Division of the U.S. Department of Justice online, by mail, or by fax to file a complaint.

Resources For Substance Abuse In Hearing-Impaired Communities

Many municipal and state health departments, as well as statewide advocacy organizations, offer resources specific to the needs and issues faced by people with sensory disabilities.

State and local resources include:

You can find more state-specific resources with the National Association of the Deaf’s National ASL Resource Directory.

In addition to these local resources, there are also a number of national advocacy organizations and resources to help individuals find and advocate for accessible addiction treatment services:


CaringWorks is an agency based in Atlanta, Georgia that specifically serves to connect individuals with housing, mental healthcare, and other essential support services.

The agency also has a grant-funded Deaf and Hard of Hearing Program that serves to connect housing-insecure D/HH individuals with stable housing and recovery services.

Deaf Off Drugs And Alcohol

Deaf off Drugs and Alcohol is a grant-funded project led by Wright State University’s Substance Abuse Resources and Disability Issues (SARDI) Program.

This project offers online recovery meetings, educational resources, and case management to help individuals find suitable treatment options.

Hands And Voices

Hands & Voices is a parent-led nonprofit organization with chapters in several states across the country.

This organization focuses on advocacy, education, and early intervention resources for parents of youth with hearing loss.

Hearing Loss Association of America

The Hearing Loss Association of America is the nation’s leading advocacy organization for people with hearing loss.

Primary resources:

  • Know your rights
  • Get in the Hearing Loop program
  • Find a local or state chapter near you

On their website, they offer a wide range of educational resources, helpful links for families, and information about how to find health services and hearing checks near you.

National Coalition On Mental Health And Deaf Individuals

As part of the National Association of State Mental Health Program Directors, this national coalition offers a number of resources for the deaf community.

For instance, they offer educational resources and technical assistance for state mental health departments to help them increase their accessibility.

National Association Of The Deaf

The National Association of the Deaf is considered a leading civil rights organization for those with deafness or hearing impairment.

Resources include:

Registry Of Interpreters For The Deaf

The Registry of Interpreters for the Deaf is a national professional organization that offers resources for how to hire or become an interpreter.

They offer professional development resources, a certification program, as well as information on the ADA, state-by-state regulations, and a disability advocacy toolkit.

Substance Abuse And Mental Health Services Administration (SAMHSA)

SAMHSA is a federal health agency that offers a range of educational resources, treatment locator tools, and resource guides for individuals and families affected by addiction.

Relevant resources include:

For Loved Ones Of Those Struggling With Addiction

Substance abuse doesn’t just affect individual people. It affects the people who care about them: their friends, families, neighbors, and close coworkers.

Taking care of yourself as a caregiver or loved one of someone struggling with addiction is just as important as helping guide someone towards addiction treatment.

Resources for families and loved ones:

Recovery from addiction is possible. For more information on how to find addiction treatment for yourself or a loved one with hearing loss, please refer to the resources shared on this page.

This page does not provide medical advice. See more

Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.

These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on April 19, 2021

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