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  • Brittany Montes, Psy. D.

Childhood Sexual Abuse and the Connection to Alcohol and Drug Abuse

Childhood abuse is a pervasive problem that spans every culture throughout the world.  In the United States alone, 3.3 million reports of child abuse involving over 6 million children have been reported (Childhelp, 2012).  However, these numbers are not likely accurate as many cases of childhood abuse go unreported (Childhelp, 2012). Furthermore, as many of 2/3 of those currently in substance abuse treatment programs report experiencing some form of childhood abuse or neglect.  Childhood sexual abuse is currently the most widely researched due to the severity and pervasiveness of this form of abuse.  Therefore, it is the best understood form of abuse and its connections to alcohol and drug use have been widely explored as a result. 

Illustration representing drug and alcohol abuse

Kilpatrick et al. (2000) conducted a study involving 4, 023 adolescent participants.  Overall, their research indicated that the experience of childhood sexual abuse tends to increase the risk for current substance abuse and/or dependence (Kilpatrick et al., 2000).  Results also indicated that African-American participants were at an approximately one-third higher risk for substance abuse and dependence than their peers (Kilpatrick et al., 2000).  While researchers were unsure about the exact nature of this difference between racial groups, differences in familial use and economic status could serve as underlying risk factors for African-American participants (Kilpatrick et al., 2000).

Another study examined 220 male social drinkers to explore the connection between the experience of childhood sexual abuse, sexual behavior, and alcohol abuse (Davis et al., 2012).  Overall, results indicated that males with a history of childhood sexual abuse were more likely to experience earlier and increased alcohol and drug use in adolescence and adulthood (Davis et al., 2012).  Results also indicated that there is an association between the experience of childhood sexual abuse and using alcohol before intercourse as well as with acts of sexual assault (Davis et al., 2012).  Furthermore, results indicated that when these increased entitlement cognitions were paired with the cognitive impairment effects of alcohol, participants may have re-doubled their focus on salient features and cognitions associated with sexual entitlement (Davis et al., 2012).

In another line of research, McMackin, Keane, and Kline (2008) examined a cross-section of research to further explore the unique aspects that clergy-perpetrated sexual abuse presents.  Additionally, researchers strived to emphasize the concept of providing a voice for individuals who have survived such abuse (McMackin et al., 2008).  Their study indicated that focus groups consisting of survivors of clergy-perpetrated sexual abuse indicated symptoms of posttraumatic stress disorder, substance abuse, affective lability, and relational conflicts (McMackin et al., 2008).  The results of this study are vitally important as they indicate that the experience of childhood sexual abuse plays a bigger role in increasing risk factors than the relationship of the perpetrator to the child.  Specifically, the experience of childhood sexual abuse itself appears to serve as a risk factor; a relationship to the perpetrator may, however, serve to exacerbate this risk factor.


Similarly, Schraufnagel, Davis, George, and Norris (2010) studied 280 heterosexual males aged between 21 and 35 years old as a part of a study on alcohol and sexual decision-making.  Researchers found that the experience of childhood sexual abuse was positively associated with preteen alcohol use (Schraufnagel et al., 2010).  Furthermore, results indicated that increased severity of childhood sexual abuse was associated with an earlier age of onset of drinking behavior (Schraufnagel et al., 2010).

In a different line of research, Sartor et al. (2007) studied 3, 536 female twins between the ages of 18 and 29 years.  Results indicated that the experience of childhood sexual abuse was associated with higher rates of lifetime alcohol and drug use and dependence (Sartor et al., 2007).  Additionally, researchers found that the experience of childhood sexual abuse was associated with a risk for consumption of one’s first alcoholic drink between the ages of 12 and 13 years old (Sartor et al., 2007).  Finally, researchers found that the prevalence of lifetime alcohol dependence was elevated among participants with a history of childhood sexual abuse (Sartor et al., 2007).

In a separate study, Asberg and Renk (2012) examined substance use based coping as a mediator between trauma symptoms and substance use consequences in 111 incarcerated females who were also survivors of childhood sexual abuse.  Results indicated that trauma symptoms predicted the severity of substance use consequences (Asberg & Renk, 2012).  Specifically, they found that a higher endorsement of trauma symptoms was associated with an increased severity of substance use consequences (Asberg & Renk, 2012).  Additionally, they found that this relationship was mediated fully by avoidance coping, specifically, the use of substances in coping with trauma symptoms (Asberg & Renk, 2012).  

Walsh et al. (2012) recruited 1,808 female adolescent participants to complete interviews over the course of 3 years.  Researchers sought to examine the effect of childhood sexual victimization on the longitudinal trajectory of posttraumatic stress disorder symptoms and binge drinking behaviors among adolescent females (Walsh et al., 2012).  Overall, researchers found that sexual trauma was associated immediate and long-lasting elevations in posttraumatic stress disorder symptoms (Walsh et al., 2012).  

However, sexual trauma was not associated with initial or lasting elevations in binge drinking behaviors (Walsh et al., 2012).  It is notable, however, that the experience of sexual victimization was associated with acute increases in posttraumatic stress symptoms and binge drinking behavior (Walsh et al., 2012).  This suggests a need for binge drinking related interventions to help reduce further sexual victimization related to alcohol use (Walsh et al., 2012).  Keyes, Hatzenbuehler, and Hasin (2011), on the other hand, reviewed the relationship between 4 different stressors and alcohol use disorders through the examination of epidemiologic studies.  Overall, researchers found that childhood maltreatment serves as a risk factor for an early onset of drinking in adolescence and as a risk factor for alcohol use disorders in adults (Keyes et al., 2011).

Finally, Maniglio (2011) completed a meta-analysis consisting of 6 reviews and approximately 200 studies.  Results indicated that a history of childhood sexual abuse is a statistically significant risk factor for substance related problems (Maniglio, 2011).  However, these results were general and non-specific in nature (Maniglio, 2011).  Specifically, results were not specific about the type of the drug use or the extent of this use (Maniglio, 2011).

In sum, research supports a strong connection between the experience of childhood sexual abuse and alcohol and drug abuse.  Specifically, the experience of childhood sexual abuse serves as a risk factor increasing one’s chances of using and/or abusing drugs and alcohol across the board.  Research also indicates that, in general, males experience increased negative effects from the experience of childhood sexual abuse.  That is, they are more likely to engage in behaviors involving alcohol and drugs, experience an earlier onset, and exhibit an increased amount of sexually aggressive behaviors and beliefs.  However, it is clear that the experience of childhood sexual abuse increases ones likelihood that he or she will engage in behaviors related to drug and alcohol abuse across the board.

About the Author

Dr. Montes is a licensed clinical psychologist and co-owner of Cognitive Behavior Therapy Center in Chesapeake, VA. 


Asberg, K., & Renk, K. (2012). Substance use coping as a mediator of the 

relationship between trauma symptoms and substance use 

consequences among incarcerated females with childhood 

sexual abuse histories. Substance Use & Misuse, 47(7), 799-808.

Childhelp. (2012). National child abuse statistics. Retrieved from 


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