AIMS: This study investigated whether child abuse (CSA) was
associated with earlier substance use and greater severity of
substance dependence and what aspects of CSA might predict substance
abuse. DESIGN: The study compared (a) drug and alcohol treatment
clients with and without a history of CSA and (b) CSA survivors
outside drug and alcohol treatment who did or did not have current
substance abuse. SETTINGS: Semi-structured interviews took place at
participants' homes, treatment agencies or the research
centre. PARTICIPANTS: Volunteer participants included 100 women
recruited from drug and alcohol treatment programmes and 80 CSA
survivors recruited through CSA counseling services and medial
advertising. MEASUREMENTS: The results focus on data from the Opiate
Treatment Index, Severity of Alcohol Dependence Questionnaire,
Substance Dependence Scale, Self-Esteem Inventory and self-reported
histories of CSA. FINDINGS: There were no differences between CSA
survivors and other drug and alcohol treatment clients in their
severity of dependence. Women with a history of CSA more frequently
identified stimulants as their main problem drug and reported an
earlier age of first intoxication and earlier use of inhalants. Among
abused CSA survivors outside drug and alcohol treatment, women with
current substance abuse had typically been abused during adolescence
by someone outside the family, whereas those without current substance
abuse were typically abused by family members before
adolescence. CONCLUSIONS: The results suggest that adolescence is a
crucial time for the influence of CSA experiences on substance
abuse.