Substance Use Disorder As A Consequence Of Childhood Sexual Abuse(Guest Post)

A guest post by Matthew Sandusky, CEO of the Peaceful Hearts Foundation.MatthewSandusky_20140852_pp

Childhood sexual abuse, or CSA, is a term used to describe any adult or peer behavior that coerces or forces a child into sexual activity, or frames a child in a sexual context. While some of these behaviors involve direct contact with a child, others involve voyeurism and other non-contact activities. When compared to adults with no history of CSA, adults who experience sexual abuse during childhood have significantly greater chances of developing a serious addiction to drugs or alcohol. While rates of sexual abuse are higher in females than in males, male victims of abuse have a greater chance of developing addictions during adulthood.

The long-term effects of childhood sexual abuse include depression, anxiety, suicidality, revictimization, substance addiction and other addictions, low self-esteem, and difficulties with interpersonal relationships. About half of all men and two-thirds of all women in drug treatment centers report past sexual or physical abuse.

Many victims turn to drugs and alcohol for various reasons that include:

  • A mechanism to cope or escape the trauma of sexual abuse
  • A way to reduce the feelings of isolation and loneliness
  • Self medication
  • To improve self-esteem and self confidence
  • A form of self-destructive behavior or self-harm

Comorbidity is a major factor in developing a substance addiction problem. An addiction is classified as a mental illness in that it is dynamic mental atrophy resulting from a reliance on a substance. Like all mental illnesses, substance addiction doesn’t discriminate- it affects people from all ethnic, cultural and socioeconomic backgrounds. Research shows that a large rate of individuals who have a substance addiction problem also have a mental disorder such as depression, anxiety and post-traumatic stress disorder.

My personal struggles with drug and alcohol addiction

My adopted father sexually abused me for 9 years as a child. I developed posttraumatic stress disorder (PTSD) when I made the decision to finally disclose my abuse as a child. Until the onset of PTSD, I had lived a limited lifestyle. From the age of 13 I had self-medicated with alcohol and drugs to avoid confrontation with feelings and memories of the sexual abuse, to keep depressive affect and anxiety under control, and to maintain my ability to function at work. I had visited hospitals and doctors for many physical complaints but didn’t trust mental health experts enough to seek their help.

I was overwhelmed by memories and feelings from my childhood sexual abuse and felt revictimized by them. I felt desperate, ashamed, helpless, and abandoned by everyone. I just wanted to die and was sure that my death was imminent. I tried to gain control over my pain by using extremely high amounts of drugs and alcohol. Nothing worked and at 17 I attempted suicide with over-the-counter pills and alcohol. When the suicide attempt failed I turned back to illegal drugs and alcohol and my dependence became a full-blown addiction. It was not until I came to understand, through therapy at 33 years of age, that the denial, despair, shame, and helplessness that I felt in the context of my substance addiction was the same emotions I felt during the time of my sexual abuse that I was able to start working on myself honestly.

Judith Herman offers a 3-stage recovery model…

  • Stage 1– setting goals of personal safety, genuine self-care, and healthy emotion-regulation capacities
  • Stage 2– remembrance and mourning with the main work being discussing memories, working through grief, and establishing a solid foundation of understanding, safety, stability and self-regulation skills.
  • Stage 3– recovery focuses on reconnecting with people, meaningful activities, and other aspects of life.

Research shows that addiction isn’t a matter of moral failing but rather a chronic condition that requires treatment. Those struggling with drug addiction and addiction issues can find the help they need. No matter how long you have taken drugs or alcohol, recovery is always possible. You can live a healthy and fulfilling life after addiction.

Recovery is a bold step, requiring commitment and determination. However, the strength to end drug and alcohol addiction and embrace health is within everyone.




  Briere J: Long-term clinical correlates of childhood sexual victimization. Annals of the New York Academy of Sciences 528:327-334, 1998 CrossRef