Child abuse and the clinical course of drug misuse

R. Browne and J. O'Connor

Drug Treatment Centre, Trinity Court, 30/31 Pearse St, Dublin 2, Republic of Ireland

EDITED BY MATTHEW HOTOPF

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.[Free Full Text]

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.[Abstract/Free Full Text]

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.