Disability-Related Differences in Substance Use Among U.S. Young Adults

People with (vs without) disabilities may be at greater risk for substance use, but limited research has explored the use of various substances among people with disabilities. This study examined differences in substance use among U.S. young adults with versus without disabilities.

Survey data were derived from an internet-based, purposive national sample of U.S. young adults (aged 18-34; N = 3458; M_age = 26.4; 61.2% female, 63.2% White). Multivariable regression analyses examined disability status, subtype (hearing, vision, cognitive, mobility), and number of disabling limitations in relation to: past 30-day cannabis and tobacco use frequency (ordinal logistic regression, adjusted odds ratios [aOR]); past 30-day binge drinking (negative-binomial regression, adjusted incidence rate ratio); and past 6-month non-medical stimulant and opioid use (logistic regression, aOR).

One-third of participants (30.2%) reported having at least 1 disability. 40.5%, 37.8%, and 33.1% participants reported past 30-day cannabis use, tobacco use, and binge drinking, respectively. 8.7% and 5.3% of participants reported past 6-month non-medical stimulant and opioid use, respectively. Participants with (vs without) disability had greater odds of more frequent cannabis use (aOR: 1.44, 95% confidence interval: 1.23-1.69), more days of tobacco use (1.61, 1.33-1.93), and 3 times higher rates of both non-medical use of stimulants (3.02, 2.23-4.09) and opioids (3.00, 2.11-4.28). Mobility/complex activity limitations were associated with more days of binge drinking (1.55, 1.08-2.21). Compared to participants without disabilities, a greater number of disability subtypes was associated with higher likelihood of using all substances studied, except for binge drinking.

Young adult substance use patterns differ by disability status, disability subtype, and number of disabling limitations, as well as by specific substances. Future research should prioritize tailored prevention and treatment strategies to address substance use within this underserved population with disabilities.