VISTAS Online is an innovative publication produced for ACA by Dr. Garry R. Walz and Dr. Jeanne C. Bleuer of Counseling Outfitters, LLC. Its purpose is to provide a means of capturing the ideas, information and experiences generated by the annual ACA Conference and selected ACA Division Conferences. Papers on a program or practice that has been validated through research or experience may also be submitted. This digital collection of peer-reviewed articles is authored by counselors, for counselors. VISTAS Online contains the full text of over 900 proprietary counseling articles published from 2004 to 2017.
Spinal Cord Injury and Substance Abuse: Implications for Rehabilitation Professionals
David A. DeLambo, Kananur V. Chandras, Debra Homa, and Sunil V. Chandras
Roughly 11,000 individuals per year acquire spinal cord injuries (SCI; Rehabilitation Research and Training Center [RRTC], 2006). The overall population living with spinal cord injury is estimated to be 250,000- 400,000. The majority of these individuals are single (53%) and male (82%), with disability onset occurring between the ages of 16 and 30. The major factors causing this disability are vehicle accidents (44%) and acts of violence (24%; National Spinal Cord Injury Association [NSCIA], 2007). More importantly, as many as 40 to 80 percent of these injuries involved alcohol and drugs at time of onset (Substance Abuse and Resources and Disability Issues [SARDI], 2007). Unfortunately, a vast number of spinal cord injury (SCI) survivors continue to use alcohol and other substances (Benshoff & Janikowski, 2000; DeLambo, Chandras, Chandras, & Eddy, 2006), despite the many grave consequences, including significant risk of re-injury (Chandras, Chandras & Eddy, 2009, Krause, 2004); major depression (Elliot & Kennedy, 2004); suicide (Rish, Dilustro, Salazar, Schwab & Brown, 1997); life threatening drug synergistic effects from prescription drugs (e.g., barbiturates) combined with alcohol (Benshoff & Janikowski, 2000); high risk behaviors (Alston, 1994); increased intoxication levels due to weight loss; decreased immune system functioning; urinary-tract kidney and bladder infections; skin conditions and pressure ulcers; dehydration; autonomic dysreflexia; overstretched bladder; and stomach and intestinal bleeding (Bombardier, 2003; Chandras et al., 2009). In addition, individuals with SCI who continue to abuse substances are more likely to experience anger and anxiety (Greer & Walls, 1997); reduced quality of life (Tate, Forchheimer, Krause, Meade, & Bombardier, 2004); psychosocial distress (Livneh, 2000); lower functional independence scores and longer periods of inpatient rehabilitation (Bombardier, Stroud, Esselman & Rimmele, 2004); social isolation; and unemployment (Benshoff & Janikowski, 2000). For these reasons, it is imperative that rehabilitation professionals address substance abuse issues with SCI clients (Chandras et al., 2009).