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A new study published in the Disability and Health Journal examined the prevalence of illicit drug use among college students with physical, cognitive, and other disabilities, and their counterparts without disabilities. 

“Our aim was to investigate whether there were differences in illicit substance use between students with disabilities and their peers without disabilities,” study author Myriam Casseus told us. “Numerous studies have found high rates of substance use among adults with disabilities and young adults/college students. However, there has been little research on drug use among college student with disabilities.”

Approximately one third of all adolescents with mental illness become regular alcohol drinkers or have used illicit drugs by the age of 18, explained Casseus. Yet, very little is known about how this population fares after enrolling in college. 

“Even more striking is the lack of information on substance use among students with other forms of disabilities,” Casseus told us. “This gap in research has significant implications for public health.”

Although most young adults with disabilities continue on to postsecondary education, much remains unknown about this population. From a public health policy standpoint, identifying disparities in illicit drug use in this population is important to determine how best to direct resources in order to reduce these disparities.

“Our study used data from the 2017 National Survey on Drug Use and Health (NSDUH),” Casseus told us. “NSDUH is an annual survey that provides information about the use of illicit drugs, marijuana, alcohol, and tobacco among members of the U.S. civilian, noninstitutionalized population aged 12 and older, including residents of noninstitutionalized group quarters such as college dormitories. It is a nationally representative sample, and also includes questions on health status, conditions, health care access, and utilization.”

The researchers found that a majority of college students reporting a disability had a cognitive limitation. Students with any disability had a higher prevalence of illicit drug use and significantly higher odds of ever having used illicit drugs. Compared to their peers with no disabilities, students with disabilities were more likely to have misused psychotherapeutic drugs (i.e., pain relievers, tranquilizers, stimulants, and sedatives) in the past year and had nearly twice the odds of misusing prescription pain relievers in the past month. Additionally, students with disabilities were three times more likely to meet criteria for past-year dependence or abuse of any illicit drug. 
 
“The results were somewhat surprising because while alcohol and cannabis use are very common on college campuses, we were not expecting such high proportions of students with disabilities using cocaine, heroin, and OxyContin,” Casseus told us. “Findings from this study highlight the significant burden of illicit drug use and illicit drug use disorders among students with disabilities in postsecondary institutions.”

Drug use and drug use disorders can affect college students with disabilities during a critical neurodevelopmental period, impairing cognition and negatively impacting academic achievement, Casseus explained. These behaviors can increase medical noncompliance and thus contribute to poor health, especially in students with comorbid conditions. Students who are using illicit drugs or misusing psychotherapeutics put themselves at risk for overdose and other negative outcomes. These substances can interact with prescribed medications and interfere with successful adherence to rehabilitation services.  

“Higher prevalence of substance use may be due, in part, to individuals with disabilities self-medicating,” Casseus told us. “In that case, referral to health care providers is necessary for medical screening and intervention.”
Casseus goes on to explain that it is well established that young adults are especially vulnerable to mental illness and drug use disorders.  Having a disability may increase their risk for substance use. 

“Hence, it is important to identify these young people, develop appropriate outreach and engagement processes, and create access to effective clinical and supportive interventions in the college/university setting,” Casseus told us. “These results indicate the need for robust coordination between offices of disability services and substance use services on campuses.”