Recent trends in substance abuse among persons with disabilities compared to that of persons without disabilities.

BACKGROUND: Substance abuse (SA) is a grave and pervasive social problem associated with severe personal and social costs that affect persons with disabilities disproportionally. Most previous research has found SA prevalence to be greater among persons with disabilities than among those without disabilities. OBJECTIVES: To compare prevalence between persons with disabilities and persons without disabilities for different substances of abuse, and recent SA trends. METHODS: The authors examined nine years of nationally representative data estimates from the National Survey on Drug Use and Health, comparing previous month prevalence of self-reported SA on a per-substance basis among community residing persons with disabilities and their peers without disabilities, using a logistic regression model that accounted for demographic factors. RESULTS: Prevalence of overall substance abuse (a composite measure) was level over time, at 34% for persons without disabilities and 40% for persons with disabilities. The SA prevalence among persons with disabilities closely paralleled that of other persons over the period 2002-2010 for each substance examined, but at a statistically significant higher level, with the exception of alcohol abuse, which was significantly lower. Time trends were relatively stable for both populations, with the exception of decreases in cocaine use and recent dramatic increases in marijuana use and oxycodone abuse. CONCLUSIONS: Given that substance abuse among persons with disabilities is markedly more prevalent than among other persons for most substances, findings indicate a need for accessible, targeted prevention programs and a potentially overwhelming demand for accessible SA treatment services and facilities.

Linkage to HIV care for jail detainees: findings from detention to the first 30 days after release.

Of people living with HIV in the US, ~16 % or over 150,000 individuals passed through a correctional facility in 2006. Given the enormous impact of HIV within incarcerated populations, facilitating continuity of care from jails to the community is particularly important in reducing morbidity and mortality for releasees. Grantees participating in the Enhancing Linkages to HIV Primary Care in Jail Settings Initiative developed models for identifying HIV-positive detainees during incarceration and linking them to care following release. In this sample of 1,021 HIV-infected releasees, 79 % received clinical services and 74 % received additional community services within 30 days post-release. Our analysis found several significant factors associated with linkage including: receipt of HIV or medication education in jail, having a completed discharge plan at release, staff awareness of clients' release date, and stable housing on the 30th day post-release. In addition, a subset of participants who had both jail and community viral load assessments showed a statistically significant increase in suppressed viral load. EnhanceLink data suggest that jails may be effective settings to engage individuals in care.