Drug Treatment Centre, Trinity Court, 30/31 Pearse St, Dublin 2, Republic of Ireland
Charnaud & Griffiths (2000) in response to the finding of increased psychiatric symptoms in female drug users by Marsden et al (2000) postulate that this finding may be a sequela of earlier child abuse. It is interesting to note the high incidence of childhood sexual abuse found in their study population based in Cornwall. In a Dublin sample, the level of sexual abuse for both males and females was considerably lower (21%). However, the effects of abuse appeared to have a significant influence in subsequent clinical progression of substance misuse. Those patients with a history of sexual abuse in the past had a significantly younger mean age of first opiate use (16.7 years v. 19.1 years for those without a history of sexual abuse) (Browne et al, 1998). The duration of drug misuse was also considerably longer (mean 10.8 v. 8.4 years).
We would support the suggestion of Charnaud & Griffiths (2000) that the evaluation of previous history of sexual abuse can predict the best plan of treatment for these patients. We would suggest that the long-term clinical progression of sexually abused drug misusers is that of more rapid progression to intravenous drug misuse with all the prognostic features that this implies.
REFERENCES
Charnaud, B. & Griffiths, V. (2000) Drug
dependence and child abuse (letter). British Journal of
Psychiatry, 177,
84.
Marsden, J., Gossop, M., Stewart, D., et al
(2000) Psychiatric symptoms among clients seeking treatment
for drug dependence. Intake data from the National Treatment Outcome Research
Study. British Journal of Psychiatry,
176,
285-289.
Browne, R., Keating, S. & O'Connor, J. (1998) Sexual abuse in childhood and subsequent illicit drug abuse in adolescence and early adulthood. Irish Journal of Psychological Medicine, 15, 123-126.