Background
People with disabilities (PWD) are at higher risk of experiencing substance use (SU) disorders than those without a disability. While treatment for SU reduces mortality and morbidity, currently, there are no national-level studies examining differences between US adults with and without disabilities in terms of SU treatment receipt, perceived need for treatment, and barriers to receiving treatment. To fill this gap, we employed data from the most recent National Survey on Drug Use and Health (NSDUH-2022).

Design
This cross-sectional study examined NSDUH-2022 data (n=45,546 adults) on self-reported disability and past-year SU disorder, SU treatment, unmet treatment need, and treatment barriers. Analyses included weighted prevalence estimates, chi-squared tests (corrected for the survey design), and binomial logistic regression.

Results
An estimated 11.8% of adults with a disability, versus 3.8% without a disability, reported past-year SU treatment. For adults with a past-year SU disorder who did not receive treatment, reporting a disability was associated with nearly double the odds (Adjusted Odds Ratio [AOR] 1.94; 95% Confidence Interval [CI], 1.312.87) of “unmet need” for SU treatment (after adjusting for demographics). Among adults who reported an “unmet need” for SU treatment, barriers related to cost and stigma were reported more frequently in those with, compared to without, a disability.

Conclusions
Findings highlight elevated SU treatment need and barriers for adults with disabilities. Understanding the intersection of disability with the cascade of care from access to screening to diagnosis and treatment of SU among PWD is critical to improving health outcomes in a deeply marginalized and stigmatized population.