This paper reviews literature related to substance abuse and persons with disabilities. The paper distinguishes between congenital disability and trauma-generated conditions and the impact on drug use. Drug use patterns are also differentiated by type and severity of disability categories including mental illness, orthopedic and physical disability, learning disability, hearing impairment and deafness, visual impairment, and developmental disability or mental retardation. Special problems when studying substance abuse among the disabled include low awareness of the problem among family members, friends, and professionals; sampling problems in substance abuse research; and limited resources for research. Substance abuse risk factors that are unique to individuals with disabilities include societal entitlement of drug use by individuals with disabilities, physical health problems, long-term use of medication, atypical childhood experiences, sexuality, and chronic pain. Persons with disabilities may need specialized or additional services for chemical dependency treatment. Development of these services requires consideration of such issues as use of a treatment model other than the disease model, use of therapeutic drugs in the form of prescribed medications, use of "handicapped" behaviors by clients, involvement of significant others, and aftercare. Future directions are discussed. (Includes 27 references) (JDD)