People with disabilities receive diagnoses of alcohol use disorder (AUD) at dramatically higher rates than non-disabled adults in the United States, according to a large observational analysis published in Drug and Alcohol Dependence Reports. The study analyzed commercially insured records from 2016–2023, providing one of the most detailed views to date of how disability status and sex shape AUD diagnosis patterns in real-world health care.
The central finding is stark: adults with disabilities were diagnosed with AUD at more than three times the rate of adults without disabilities. This elevated risk persisted across disability categories, indicating that the difference is not confined to one subgroup or a single clinical profile.
Rates also rose during the study period. Overall AUD diagnosis increased at an average annual rate of 5.4%, climbing from 85 per 10,000 people in 2016 to 128 per 10,000 in 2023. For adults with disabilities, diagnoses rose from 223.4 per 10,000 to 312.2 per 10,000, while non-disabled adults increased from 61 per 10,000 to 94.3 per 10,000.
The study sharpened the picture by disability type. Adults with serious mental illness—including severe depression, schizophrenia, and bipolar disorder—showed the highest AUD diagnosis rates, exceeding those of non-disabled adults by more than tenfold. Adults with acquired brain injuries such as traumatic brain injury and stroke had the second-highest rates, at over five times the rate.
Sex-specific patterns revealed further risk. Men with disabilities had the highest AUD rates overall, yet women with disabilities also experienced elevated AUD diagnoses compared with both non-disabled men and non-disabled women, reflecting a complex interplay between biological vulnerability, social context, and drinking patterns.
Importantly, the results do not simply follow drinking prevalence. Adults with disabilities were reported to be less likely to drink alcohol overall than adults without disabilities, yet they were diagnosed with AUD far more often—suggesting that diagnostic, clinical, or care pathways may be detecting more severe or earlier emerging disorder.
Researchers emphasize that AUD is a chronic condition linked to substantial morbidity and mortality risk. They argue that clinicians should treat disability status as a risk indicator for AUD screening and tailor interventions accordingly, rather than waiting for substance-use behaviors to become obvious.
The work is funded by the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse. The authors are now extending the analysis to Medicaid and other commercial populations to evaluate whether disabled people face disparities in access to, or quality of, AUD treatment.
In the wake of these findings, the team is calling for targeted public health action: systematic AUD screening for patients with disabilities, person-centered treatment options, and reductions in stigma and bias that can block equitable care.
Subject of Research: People
Article Title: Alcohol use disorder diagnoses among commercially insured US adults from 2016 to 2023, by disability status and sex
News Publication Date: Tuesday, July 14, 2026
Web References: http://dx.doi.org/10.1016/j.dadr.2026.100461
References: 10.1016/j.dadr.2026.100461
Image Credits: Not provided
Keywords: alcohol use disorder, disability, sex differences, serious mental illness, acquired brain injury, diagnosis trends, public health, stigma
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