Undetected substance abuse among vocational rehabilitation clients.

This dissertation investigated rates of detected and undetected substance abuse among vocational rehabilitation applicants. The Substance Abuse Subtle Screening Inventory (SASSI) was administered to adults who applied to one Rehabilitation Services Administration (RSA) office during a consecutive four-month period. Subjects supplied demographic data and information regarding their disabilities. RSA disability codes, DSM III-R codes assigned by psychologists, and reasons for case closures were provided by counselors. Results of the study indicated a 41% rate of substance abuse among the 134 applicant-subjects. Within this sample 31% of the subjects evidenced some indication substance abuse in combination with another disability, while 10% had only indications of alcoholism or drug abuse. Seventeen percent of the sample self-disclosed problems with alcohol or drugs. Among the 41 applicants determined eligible to receive vocational rehabilitation services, a 27% rate of undetected substance abuse was found. For purposes of this study undetected substance abuse was defined by a self-disclosure, SASSI profile, or DSM III-R code indicative of substance abuse that was not reflected in the subject's assigned RSA disability code(s)