Substance Abuse is a term used to describe the misuse of legal and illegal substances to the point of intoxication or inebriation. Substances grouped into this category include alcohol, prescription medications, illegal drugs and psychoactive chemicals. Substance abuse is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a maladaptive pattern of substance use leading to clinically significant impairment or distress as manifested by one (or more) of the following, occurring within a 12 month period:
- Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home – e.g. repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household.
- Recurrent substance use in situations in which it is physically hazardous – e.g. driving a vehicle or operating machinery when impaired by substance use.
- Recurrent substance-related legal problems – e.g. arrests for substance-related disorderly conduct
- Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance – e.g. arguments with spouse about consequences of intoxication, physical fights.
Symptoms of substance abuse or dependence include a loss of control over substance use, devotion of increasing amounts of time and effort into obtaining and using the substance and physical and mental health problems such as liver disease, hepatitis or psychosis directly caused by substance use.
Sexual abuse is defined as sexual-based acts or events that cause trauma to the victim. These events or acts include sexual assault, child molestation, rape, incest, hate crimes based on gender identity or sexual orientation and sexual harassment. Sexual abuse can cause significant physical and mental harm to the victim, some of whom take a long time to be able to move on from the abuse. Studies have shown that there is a strong correlation between the history of sexual abuse and the manifestation of addictive behavior, especially in women. 1 out of every 6 women and 1 in 33 men in America have been the victim of sexual assault or rape in their lifetime. 15 percent of victims are under age of 12. Sexual abuse victims are 3 times more likely to suffer depression, 6 times more likely to suffer post-traumatic stress disorder, 13 times more likely to abuse alcohol and 26 times more likely to abuse drugs than those who have not been sexually abused.
Sexual Abuse increases Risk of Substance Abuse
Sexual abuse in any form can lead to major problems for the victims. Substance abuse, post-traumatic stress disorder, poor coping skills, antisocial behavior, depression, anxiety, future victimization, low self-esteem and problems in relationships are all a consequence of sexual abuse. Some studies have suggested that people who are the victims of sexual abuse may have an increased risk for substance abuse. Substances are used by victims for a number of reasons which include:
- A mechanism to cope or escape the trauma of sexual abuse
- A way to reduce feelings of isolation and loneliness
- A form of self medication
- To improve self esteem and boost confidence
- A form of self-destructive behavior or self-harm
Child or Adolescent Sexual Abuse
Child or adolescent sexual abuse can be defined as the sexualisation of a child or young person by an adult or peer. The abuse may include touching, penetration, voyeurism, child pornography or intercourse. The abuse may be violent and include rape, threats and physical abuse or it may be less obvious and include grooming a child to be sexual, coercion to participate or peer pressure. These sexual acts are imposed on children who lack the emotional, maturation and cognitive development to understand or to consent to these acts.
The physical and mental health effects of sexual abuse on a child or adolescent often extend into adulthood. Many will suffer from depression, post-traumatic stress disorder, anxiety, further victimization, substance abuse, self harm or even eating disorders. These issues can be mild or severe and may not be linked to childhood abuse when first diagnosed. Evidence suggests that there is a strong relationship between childhood sexual abuse and the development of adult substance abuse problems. Many of these studies focused on woman and they have found that those who were the victims of child sex abuse were more likely to have substance abuse problems and more likely yo be in treatment programs than those who had not been abused.
Co-morbidity is a major factor in the development of a substance abuse problem. An addiction in its self can be classified as a mental illness in that it is the progressive psychological deterioration resulting from a dependence on a substance. Like other mental illnesses, substance abuse affects people from all ethnic, cultural and socioeconomic backgrounds. Genetics, environment, childhood experiences, peers and trauma play a significant role in the development of an addiction. Research has shown that a significant percentage of people who have a substance abuse problem also have a co-occurring mental disorder such as depression, anxiety and post-traumatic stress disorder.
Estimates suggest that between 30-50 percent of those who are in formal drug and alcohol treatment are experiencing post-traumatic stress disorder. More than one in five individuals who has been diagnosed with depression will also have a recent history of abusing alcohol or drugs. These figures however do not account for the large number of people who suffer from substance abuse without seeking help for their problems.
Drug and alcohol addicts abuse substances to escape from painful or fearful memories, such as sexual abuse. They may not realize that they have been self-medicating the traumatic experience, or avoiding dealing with the consequences of the act and a serious dependency on a drug has developed. Self-medicating provides relief for stresses, concerns and fears and gives relief in the short term. However this is incredibly dangerous as some substances have very high addiction and abuse potential. Dealing with a traumatic experience like sexual abuse in this way is very harmful both physically and mentally.