According to the Hearing Loss Association of America, approximately 48 million Americans have some degree of hearing loss. People with hearing loss wait an average of seven years before seeking help. Unfortunately, only one in five people who would benefit from a hearing aid actually uses one. An estimated one in five American teens experiences some degree of hearing loss. Even mild hearing loss can cause a child to miss as much as 50% of classroom discussion. Those Americans with unaided hearing loss earned, on average, $20,000 less annual than those who used hearing aids or cochlear implants. There are countless barriers for people who are hearing impaired, and unfortunately, many turn to drugs and alcohol as a means to cope.
Hearing loss is prevalent across all age groups and approximately 5.2% of Americans per the American Journal of Preventative Medicine. According to the article, among younger age groups, hearing loss was independently associated with an increased likelihood of experiencing a substance use disorder. Also, hearing loss was associated with a greater likelihood of a prescription opioid use disorder. Among those aged 18 to 34 and those aged 35 to 49, hearing loss increased the likelihood of both an alcohol use disorder and prescription pain medication addiction. Overall, per the report, hearing loss is independently associated with drug addiction among those aged 49 and younger.
Substance use treatment for the deaf and hearing-impaired utilizes specific delivery methods and programs to ensure clients receive the same level of care as anyone else. Some treatment centers have added services for the deaf and hearing impaired. However, not every program across the nation provides specific services. Typically, some programs offer American Sign Language, or the client brings an interpreter with them. Visual aids are also incorporated to make the treatment process more manageable. One of the most recognized specialty treatment centers for the deaf and hearing-impaired in the Minnesota Substance Use Disorder Treatment Program. The program is an intensive outpatient chemical dependency program located at the University of Minnesota Medical Center.
However, most individuals with this disability struggle to find the treatment they need. American Sign Language is essential, but not every drug treatment program provides interpreters. Most substance use specialists have not taken additional steps to learn ASL, or it is not provided because of a lack of client demand. The rehabilitation process is the same; however, and it begins with an initial assessment, detox, therapy, and aftercare support.
Substance Abuse Among the Deaf and Hearing Impaired and the Barriers to Treatment
According to a study in the American Journal of Preventative Medicine, younger age groups within the deaf and hard of hearing community faced an increased risk of substance abuse, specifically those between the ages of 18 and 49 years old. Prescription opioid addiction is a growing problem, along with alcohol abuse within this demographic. Hearing loss was associated with a greater likelihood of prescription opioid abuse among those aged 18 to 34 years old. Also, among those aged 34 to 49, there was an increased likelihood of alcohol addiction.
Many experts feel it is a neglected problem, and there are barriers that the deaf and hard of hearing face when it comes to substance abuse treatment. According to a report published by the Minnesota Chemical Dependency Programs for Deaf and Hard of Hearing Individuals, alcohol and drug use rates for people with disabilities range from 15% to 30% of the 43 million Americans with a disability. There is little data that accurately shows the number of deaf and hard of hearing that is struggling with addiction, but much research has been done. Per the report, an estimate from the National Council on Alcoholism, for example, suggested that at approximately 600,000 men and women experienced alcoholism and hearing loss.
Some of the common barriers include a lack of proper support and services, along with language and communication barriers. There is also a lack of training among addiction professionals and those who work within the field of deafness. Deaf and hard of hearing have unique communication needs that are not always met with a drug or alcohol treatment program. Preventing many deaf and hard of hearing from entering treatment is a lack of recognition of the problem, as pointed out by the author of the report. There is a general lack of awareness of the problem of substance abuse within the deaf community. Overall, there is a lack of resources for substance abuse services. These services do not adequately meet the communication needs of the deaf community.
Within the family dynamic are problems with enabling, protecting individuals who are disabled or handicapped, which then makes the addiction worse. Financial concerns are also a big barrier because specialized treatment programs cost more. The lack of support within the recovery community because of the communication barrier makes it difficult for deaf and hard of hearing to remain in recovery. Finally, there is communication; in order for deaf and hard of hearing to attend a drug rehabilitation program, there must be access to American Sign Language, interpreters, or other visual aids. However, treatment programs are taking steps to better the situation. More interpreters are being used and registered and certified by the National Registry of Interpreters for the Deaf. Also, computer-assisted real-time transcription ensures patients understand every step of treatment.
When is Drug Rehab for the Hearing Impaired the Best Option?
As mentioned above, people under the age of 50 who are deaf or hearing impaired are at an increased risk of developing an addiction. For example, deaf individuals have twice the rate of addiction involving opioids and are more likely to misuse alcohol and other drugs. Adults under the age of 35 with hearing loss are 2.5 times more likely to have a pain medication addiction. When problems are visible, and family friends notice this, it is time to intervene and get help. However, communication barriers prevent many of the deaf and hearing-impaired from entering drug rehab programs. Overall, the problems with substance abuse and addiction are made much worse because of the disability and the motivating reasons to abuse drugs or alcohol.
Some of the risk factors for someone with a sensory or physical disability include pain, depression, social isolation, and chronic medical problems. Other risk factors include unemployment, limited education, enabling caregivers, a history of physical or sexual abuse, low socioeconomic level, and little exposure to drug education and prevention. The most commonly abused drugs within the deaf and hard of hearing community are alcohol, pain medication, and marijuana. Everyone has relatively easy access to alcohol, and people use it to manage anxiety and frustration. Pain medication is commonly prescribed to people with disabilities, increasing the risk of dependence and addiction. Marijuana is widely accepted and legal in some states, while also commonly used to manage anxiety and frustration.
According to a journal article titled Alcohol and Drug Use Among Deaf and Hard of Hearing Individuals, it says—”Overall, individuals with disabilities report higher rates of alcohol and drug use disorder than nondisabled individuals, with SUD rates approximately double to the general population.” Those are deaf and hard of hearing face an increased risk because of limited communication with hearing parents, reduced opportunities for family discussion regarding substance use, isolation, and a desire to fit in with hearing peers, along with the lack of prevention and education materials about drugs and alcohol.
Typically, substance abuse treatment is the best option for someone when they have faced a history of abuse in the family or struggle with psychological disturbances created by substance abuse. Some of the factors they face involve isolation because of the communication barrier. There is a common misconception that most people deaf and hard of hearing integrate into society seamlessly and have no problem communicating, which is not always the case. There are also problems with low self-esteem, which can be particularly high among those who are deaf or hard of hearing. Isolation and low-self esteem is a terrible combination. Problems with depression and anxiety are common, which leads to substance abuse.
Additionally, there are numerous reported cases of trauma and people with disabilities being a victim to physical, mental, and sexual abuse. For example, abuse includes intimate partner violence, sexual assault, and crime victimization. Deaf people are often vulnerable to this kind of mistreatment because of deprivation of early language development. Other problems involve conflicts within the family regarding education and communication methods, poor parental involvement, and social isolation. People with disabilities have a much more difficult time dealing with trauma and asking for help.
Many treatment programs incorporate American Sign Language, and like anyone else struggling with addiction, once family and friends notice the signs, it is time to intervene. However, when searching for treatment programs, the facility must offer the right communication options.
How does Substance Use Treatment Programs for the Hearing Impaired Operate?
The rehabilitation and treatment approach is the same as anywhere else, but the communication methods are different. Substance abuse treatment programs for the deaf and hearing-impaired utilize American Sign Language with interpreters and assistive listening devices. For example, the programs may incorporate various manuals, videotapes, DVDs, workbooks, and guides that are signed and open captioned. Interpreters help with communication during group counseling and individual counseling sessions. Assistive listening devices are used to help those who are hard of hearing with the goal that ensures communication flows easily.
The first step with rehabilitation is the evaluation or assessment in which information about the client is gathered. For example, the assessment includes data on the client’s medical background, social history, drug history, along with a clinical assessment and a communication assessment. The communication assessment is essential because it helps profile a client’s communication needs and facilitates the provision of treatment and support using the client’s preferred method of communication. The communication process for someone that is deaf or hearing impaired contributes to the outcome of treatment.
Following the assessment, the first step with rehabilitation is drug detox, and typically, the severity of withdrawal symptoms determines what detox is needed. There is a focus on communication during detox because it can be stressful managing withdrawal symptoms. Most substance abuse treatment centers have a detox program as part of the overall program. Detox would normally involve a medically supervised detox and withdrawal management or a conventional detox program. Medical detox would treat severe alcoholism, opioid addiction, and most forms of prescription drug addiction. Conventional detox usually manages street drug addiction. Detox should not be considered the only treatment approach because it will not adequately address underlying issues.
Counseling and therapy models after detox are unique to the program and may include traditional approaches like 12-step or behavioral therapies. These therapies could be incorporated with non-traditional approaches such as holistic treatment. During counseling and therapy, American Sign Language is used with the help of interpreters or counselors. Also, visual aids and close captioning to help with the rehabilitation process. Following primary treatment should be aftercare support. The treatment center may arrange for the patient to join a 12-step group with a therapist fluent in ASL. Also, there are options for sober living where ASL is used to help with a slow integration back to society.
Terminology with Substance Use Treatment for the Deaf and Hearing Impaired
|American Sign Language||is a complete natural language with the same linguistic properties as spoken languages, with grammar that differs from English. ASL is expressed by movements of the hands and face. ASL is used at substance use treatment centers for the deaf and hard of hearing.|
|Cued Speech||is a building block that helps children who are deaf or hard of hearing understand spoken languages. The child is taught to watch a person’s mouth as many speech sounds look the same on the face even though the sounds heard are not the same.|
|Deaf||is lacking the power of hearing or having impaired hearing. Deaf culture, for example, is the set of social beliefs, behaviors, art, literary tradition, history, values, and shared institutions of communities that are influenced by deafness.|
|Hard of Hearing||refers to a hearing loss where there may be enough residual hearing that an auditory device, such as a hearing aid, provides adequate assistance. Individuals that are hard of hearing are at an increased risk of substance abuse.|
|Deafblind||is having severe impairment of both hearing and vision. Unfortunately, substance abuse is a common problem among many who are deaf and blind.|
|Hearing Impaired||covers a broad spectrum of any individual with a less than average hearing level. Hearing impaired and hard of hearing are interchangeable terms used.|
|Individuals with Disabilities||are defined as persons with a physical or mental impairment that substantially limits one or more major life activity. A major life activity would include caring for one’s self, walking, seeing, hearing, speaking, breathing, working, performing manual tasks, and learning.|
|ASL Interpreter||is an American Sign Language interpreter who helps hard of hearing or deaf individuals understand a spoken language by converting it into sign language. ASL interpreters are used at substance use treatment programs for the deaf and hard of hearing.|
|American Deafness and Rehabilitation Association||is a national organization that brings together professionals from vocational rehabilitation, mental health, chemical health, education, interpreting, and related fields to share best practices in working with individuals who are deaf, hard of hearing, and deafblind.|
|Described and Captioned Media Program||are educational programs and services that support families and educators who have at least one student with a disability. The organization provides drug education and prevention videos and information for people who are deaf or hard of hearing.|