Sitting in AA meetings over a number of years I have been struck by the amount of stories I have heard about fellow AAs having had abusive childhoods and have always wondered how much this sort of maltreatment in childhood contributes to later alcoholism.
In my research I have found that child maltreatment has been frequently identified in the life histories of adolescents and adults in treatment for substance use disorders, as well as in epidemiological studies of risk factors for substance use and abuse.
Ample evidence exists for higher rates of substance abuse and dependence among maltreated individuals (1) so much so that alcoholism and addiction for many represent a developmental cascade.
In clinical samples undergoing treatment for substance use disorders, between one third and two thirds evince child abuse and neglect histories (2-7).
In a survey in The USA, of over 100,000 youth in 6th though 12th grade, Harrison, Fulkerson, and Beebe (1997) found that those reporting either physical or sexual abuse in childhood were from 2 to 4 times more likely to be using drugs than those not reporting abuse; the rates were even higher for youth reporting multiple forms of child maltreatment (8).
Similar findings (9,10) have been reported by Rodgers et al. (2004) and Moran, Vuchinich, and Hall (2004). Among youth with Child Protective Services documenting maltreatment, Kelly, Thornberry, and Smith (1999) reported one-third higher risk for drug use among those with an abuse history(11).
In a large epidemiological study, Fergusson, Boden, and Horwood (2008) showed physical abuse and particularly sexual abuse to be related to illicit drug use, as well as abuse and dependence (12).
It also appears that extreme economic deprivation characterizes many maltreating families who are residing in impoverished areas with substantial neighborhood disorganization and ample availability of drugs in the community(13).
Hawkins, Catalano, and Miller’s (1992) highlighted poor and inconsistent family management practices, high family conflict, and poor bonding to family as risks for adolescent substance abuse, and these factors also are characteristic of the dysfunction in maltreating families in which abuse and neglect occur.
These features are consistent with the progression of developmental failures exhibited by maltreated children (14).
Consequently, compromised adaptation in the social and academic arena contributes to association with deviant peers, who escalate the access to and modeling of substance abuse, contributing to early onset of drug use.
For many the propensity for later alcoholism and drug addiction are determined in part by genetic inheritance but all genetic transmission also relies on environmental conditions.
It would appear that abusive childhoods and emotional deprivation provide fertile grounds.
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9. Harrison PA, Fulkerson JA, Beebe TJ. Multiple substance use among adolescent physical and sexual abuse victims. Child Abuse & Neglect. 1997;21:529–539.
10. Moran PB, Vuchinich S, Hall NK. Associations between types of maltreatment and substance use during adolescence. Child Abuse & Neglect. 2004;28:565–574.
11. Kelly BT, Thornberry TP, Smith CA. In the wake of child maltreatment. Washington, DC: Office of Juvenile Justice and Delinquency Prevention; 1997. pp. 1–15.
12. Fergusson DM, Boden JM, Horwood LJ. Exposure to childhood sexual and physical abuse and adjustment in early adulthood.Child Abuse & Neglect. 2008;32:607–619.
13. Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention. Psychological Bulletin.1992;112:64–105.
14. Cicchetti D, Valentino K. An ecological transactional perspective on child maltreatment: Failure of the average expectable environment and its influence upon child development. In: Cicchetti D, Cohen DJ, editors. Developmental psychopathology: Vol. 3. Risk, disorder, and adaptation. 2nd ed. New York: Wiley; 2006. pp. 129–201