Impairment, Disability, and Substance Use Disorder

According to the social model of disability, it is not individuals' impairments, but societal barriers that cause these impairments to be disabling. Impairment refers to the "loss or abnormality of psychological, physiological, or anatomical structure or function," whereas disability is socially constructed and refers to the inability to independently complete one or more everyday tasks at a "normal" level of functioning. Existing research finds that disability serves as a chronic stressor, and those with disabilities report higher rates of substance use than their able-bodied counterparts. Therefore, this research will be among the first to combine the social model of disability with the stress process framework. It will examine the relationship between impairment and substance use and how disability, as a measure of chronic stress, may affect this relationship. More specifically, using data from the 2019 National Survey on Drug Use and Health (N = 42,739), this article examines the following two research questions: (1) What is the relationship between impairment and substance use disorder? and (2) Does disability, as a measure of chronic stress, mediate the relationship between impairment and substance use disorder? Findings reveal that those with an impairment have significantly greater odds of having a substance use disorder. However, the relationship between impairment and substance use disorder is fully mediated by disability. These findings indicate that disability or the chronic stress one faces living in an inaccessible society, not one's impairments, are what accounts for the increased likelihood of substance use disorder among individuals with disabilities.