Double trouble: alcohol and other drug use among orthopedically impaired college students.

Double Trouble Alcohol and Other Drug Use Among Orthopedically Impaired College Students

College students are challenged by opportunities to experiment with illegal drugs and by occasions when excessive drinking seems to be encouraged. It is reported that 70 to 80 percent of college students are regular - monthly or more frequent - consumers of alcohol and that only 10 percent report abstinence (Friend and Koushki 1984; Berkowitz and Perkins 1986; Johnston et al. 1986; Saltz and Elandt 1986). Approximately 25 to 40 percent of college students are reported to use marijuana (Friend and Koushki 1984; Johnston et al. 1986).

Students with severe orthopedic impairments may be unusually vulnerable to abusing alcohol and other drugs. Compounding the availability of alcohol and other drugs in many college settings is the availability to many orthopedically impaired students of medications prescribed to ameliorate the effects of their disabilities. Narcotics may be prescribed to ameliorate pain, or antidepressants may be prescribed to relieve depression associated with loss of mobility. At the same time, factors such as low self-esteem, social isolation, and unresolved anger may exacerbate tendencies toward alcohol and other drug use. Dean and colleagues (1985), in a study comparing college drug use patterns between students with and without disabilities, discovered few significant differences between the two groups in frequency and types of drug use. The disabled group reported less alcohol consumption than the nondisabled group, but illicit drug use was approximately the same. The study's disabled population of 66 students included 20 orthopedically impaired individuals, but this subset was not differentiated from other disabilities in the analysis.

Other studies provide contradictory findings. Hepner and colleagues (1980-1981) reported that approximately 25 percent of the clients at a rehabilitation center abused drugs. They also reported that 41 percent of the prescriptions received by their clients were medically unnecessary. A study of over 250 clients at a residential rehabilitation facility reported that the proportion of clients using alcohol and other drugs was much higher than the general population figure for the same average age of 26 years (Rasmussen and DeBoer 1980-1981). A recent study of 205 physically disabled adults (Meyers et al. 1988) suggested that 16 percent of the respondents drink beer on at least 14 days of the month and that the same percentage drink at least 4 beers per episode. In that same sample, 25 percent of the group use marijuana more than once a month.

Possible explanations for the reported tendency of physically impaired individuals to engage in alcohol and other drug use range from self-medication to reduce chronic pain or physical discomfort (Sullivan and Guglielmo 1985; Benedikt and Kolb 1986) to more complex psychological rationales. For example, DeLoach and Greer (1981) noted that proneness to use of fantasy as a vicarious form of experience may have unusual significance for persons with physical limitations; alcohol or other drug use may be initiated as a means of escaping reality or enhancing fantasy. In addition, Krupp (1968) suggested that trauma associated with a disabling injury may lead to at least temporary loss of control over use of mood-altering substances, and Prescott (1980) suggested that diminished physical sensation may instigate alcohol or other …