The INROADS portfolio stems from two projects: (1) INROADS-Opioids (NIDILRR-funded) and (2) INROADS-Alcohol (NIAAA-funded), each of which examine the intersection between substance use and risky use, addiction, disability, and service provision.
Given higher rates of mental and physical health issues people with disabilities are at high risk of consequences from addiction, and when paired with the facts that health care barriers are generally higher for people with disabilities (PWD), it’s clear that a comprehensive picture of how the disability community is affected by alcohol and drug problems is needed.
INROADS- Opioids
The original INROADS project (INROADS-Opioids or INROADS-O), or Intersecting Research on Opioid Misuse, Addiction, and Disability Services, was a joint research program between Brandeis University’s Institute for Behavioral Health and its Lurie Institute for Disability Policy. It examined the intersection between addiction, disability, and service provision in an effort to address the rise of opioid use disorders (OUD) among people with disabilities.
In the United States at large, opioid misuse has led to a national crisis resulting in deaths, illnesses, and other detrimental results that require a thoughtful response that focuses on the causes and systems behind the opioid addiction crisis.
INROADS-O sought to understand how and why people with disabilities misuse opioids, help them access treatment, recover from OUD, and move toward their individually defined life goals. To this end, we engaged people with disabilities and a history of addictions and used a holistic analytical approach to understand the complex systems that led to opioid misuse. This work, now complete informed the needs of people with disabilities in part by including them throughout the duration of our research.
We incorporated a multi-pronged strategy, which included a systematic literature review, analyses of national and state data on the intersection between disability and OUD, educational papers and briefs about our research, focus groups, workshops, and sponsored a special issue of the Disability and Health Journal (DHJO).
INROADS-Alcohol
INROADS-Alcohol (INROADS-A) is an active joint research program between Brandeis University’s Institute for Behavioral Health and the Boston University School of Public Health’s Department of Health Law, Policy and Management, which builds on the foundation of INROADS-O with a focus on alcohol use disorder. INROADS-O laid a foundation for understanding the intersection of disability with opioid use disorder, and traumatic brain injury (TBI) with at-risk alcohol use, and this project seeks to better understand alcohol use patterns, treatment needs, and alcohol use disorder (AUD) treatment access, quality and outcomes for people with disabilities.
The limited research to date, including from our team, suggests that people with disabilities are more likely to abstain from alcohol than non-disabled people, yet those who do use alcohol may drink in riskier ways and accelerate to problematic use more rapidly.
INROADS-A aims to (1) identify differences in alcohol use and related measures by disability status, (2) investigate disparities by disability status in alcohol-related morbidity, consequences, and access to AUD treatment among people with AUD, and (3) assess disparities by disability status in receiving quality-aligned AUD treatment and experiencing acute alcohol-related outcomes among people receiving AUD treatment.
Our approach is organized by the cascade of care framework and is informed by intersectionality, critical disability theory, and an expanded definition of health disparities that separates need-related differences from true disparities, updated to reflect methodological advances.
