Perspectives of adults with disabilities and opioid misuse: Qualitative findings illuminating experiences with stigma and substance use treatment

Abstract

BACKGROUND: Opioid misuse is a significant public health problem in the United States; however, there is a gap in knowledge regarding the experiences of individuals who have experienced both opioid misuse/opioid use disorder (OUD) and another disability. This gap in knowledge is particularly problematic because people with disabilities are more likely to have co-occurring serious mental illness, experience chronic pain, and be socially isolated, which are all independent risk factors for any substance use disorder (SUD). OBJECTIVE: The purpose of this study was to illuminate the perspectives of individuals who have both opioid misuse/OUD and another disability, focusing on their experiences accessing and engaging in SUD treatment. METHODS: We recruited adults who had lived experience with both disability and an "opioid use problem." We conducted 17 individual interviews and facilitated two focus groups with 11 participants. The interview protocol included items related to individuals' experiences with OUD/SUD treatment as well as stigma. RESULTS: Respondents encountered many barriers to receiving SUD treatment related to their disability. People with disabilities experienced added layers of stigma and other systemic barriers (e.g., lack of accommodations) that complicated treatment quality and access. This was further compounded by intersecting identities (e.g., female gender, race, homelessness). CONCLUSION: SUD treatment providers should be trained to understand and adopt accommodations critical to the unique needs of individuals with disabilities, with cultural responsiveness, to encourage successful SUD treatment and recovery.