Research shows almost two-thirds of all patients in treatment for substance abuse report physical, sexual or emotional abuse during childhood.
Majority of the information regarding the role of child abuse in addiction has been gathered indirectly through studies of drug and alcohol abuse that highlighted the underlying childhood trauma. Few studies connected stress-related disorders in adult substance abusers back to childhood abuse.
A review supported by NIDA at Harvard Medical School in Boston, conducted by Dr. Lisa M. Najavits and her colleagues, examined 49 studies involving drug-abusing women with post-traumatic stress disorder (PTSD). Child abuse is one trauma that is frequently reported by PTSD patients who are drug or alcohol abusers.
“The sheer weight of the many reports over the years certainly implicates child abuse as a possible factor in drug abuse for many people,” said Dr. Cora Lee Wetherington, NIDA’s Women’s Health Coordinator.
“But we lack hard data that clearly establish and describe the role of child ‘abuse in the subsequent development of drug abuse. Is child abuse indeed a cause of drug abuse, or is child abuse a marker for other unidentified factors?” 
Child Abuse: A Two-edged Sword
More than 1 million children in the U.S. are exposed to some form of abuse or neglect every year. Child abuse is one of the most common types of violence linked with substance abuse in a relationship that has two aspects: it can either emerge as a consequence of substance abuse or act as a causative element to a substance use disorder.
Substantiated research has demonstrated a possible association of parental substance abuse with the physical or sexual abuse of children.
A study by Miller et al. found mothers with a history of alcohol abuse to use much harsher punishments for their children than mothers with no such history.
Yet, the results from these studies still remain largely inconclusive. Factors such as physical abuse, socioeconomic status, marital or relationship issues and parents who themselves experienced abuse as a child all surmount to parental abuse.
Secondly, exposure to being abused as a child may increase the susceptibility for alcohol-related problems alongside dependence on other substances of abuse into adulthood.
This is largely validated by the self-medicating hypothesis as people begin to rely on substances of abuse to in an attempt to manage distress and fear.
Various factors likely contribute to or influence this connection such as coping skills, antisocial behavioral tendencies and psychological problems like post-traumatic stress disorder (PTSD). 
Several hypotheses have been proposed to explain why victims of child abuse and neglect may be at increased risk for substance abuse in adulthood. The substance of abuse may facilitate as the following:
- A mechanism to deal with or suppress traumatic symptoms of childhood victimization and the ensuing depression. Since alcohol and drugs hide, rather than cure, the trauma, the need for substance may persist or gradually become greater, increasing the susceptibility to substance abuse or dependence.
- A means to diminish feelings of isolation and loneliness. Several studies involving children and adolescents with a history of child abuse unearthed externalizing and antisocial behaviors to be a result of childhood abuse. Consequently, such persisting behaviors are profound indicators of substance use disorder. Researchers further suggest that children or adolescents with delinquent behaviors may frequently become involved in deviant peer groups which further promotes substance abuse.
- A tool of self-medication in order to gain control over the traumatic memories and PTSD, and boost self-esteem. 
Higher Rates In Women
Even though drug abusers generally present high rates of co-occurring PTSD, female drug abusers particularly demonstrate much greater rates of this comorbidity compared to male drug abusers.
Various studies reviewed by Dr. Najavits and colleagues showed 30 to 59 percent of women in drug abuse treatment to also be battling with PTSD. This equates to a rate two to three times higher than that witnessed among men in treatment.
Regardless of PTSD, a history of trauma was found to be even more profound among women in treatment for drug abuse. Around 55 to 99 percent of these women reported a history of physical or sexual trauma.
Most of the trauma occurred before age 18 and was commonly related to repetitive childhood physical or sexual assault. When the women are victims of both types of abuse, they are twice as likely to abuse drugs like Oxycodone, heroin, or alcohol as are those who experienced only one type of abuse.
Another NIDA-funded study illustrated women rape victims to be more drastically susceptible to abuse drugs than the women who were not victims.
Dr. Dean G. Kilpatrick of the Medical University of South Carolina discovered that over 61 percent of rapes of the 4,008 women participating in the study took place by age 17.
Out of these, half occurred by age 11. The study further continued to compare these rape victims with women who were not raped and highlighted the following trends:
- Rape victims were more than three times as likely to consume marijuana;
- The women who were raped were six times more likely to have used cocaine
- Rape victims were more than 10 times as likely to have used drugs other than cocaine, including heroin and amphetamines. 
A Stitch In Time…
Most data tracing child abuse to substance abuse is gathered through a review of past instances, which poses several problems and inconsistencies for researchers.
Memory is largely subjective and substance abusers may deliberately exaggerate the role of parents or circumstances in their retrospective accounts of their journey to drug abuse.
Despite the hurdles, once the dynamics of the relationship between child abuse and adult alcohol abuse are better comprehended, clinicians, social workers and other relevant groups can utilize the knowledge to help the victims of child abuse and prevent subsequent alcohol problems in those victims.
Such efforts could be aimed at the education of developing more positive and constructive coping mechanisms, particularly for more at-risk populations such as women with PTSD.
About the Author:
A journalist and social media savvy content writer with wide research, print and on-air interview skills, Sana Ahmed has previously worked as staff writer for a renowned rehabilitation institute focusing on mental health and addiction recovery, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.
Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. The art of using words to educate, stir emotions, create change and provoke action is at the core of her career, as she strives to develop content and deliver news that matters.
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Published on June 9, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on May 26, 2017
Published on AddictionHope.com