childhood sexual abuse

Even if you do not know anything about sexual abuse or substance abuse, you are probably not surprised to learn that there is a connection between them. As an outside observer, you might have noticed that where drugs and alcohol are involved, children are often not safe. Substance abuse can bring out the worst in people.

It might surprise you to learn, though, that victims of childhood sexual abuse often grow up to abuse substances themselves. You might think having survived a terrible trauma in childhood, possibly at the hands of someone with an addiction, a person would want to get as far away from drugs as possible when they grew up.

In reality, though many children survive abuse in their childhood, they do not heal emotionally until much later in life. It is that emotional wound that often leads them to drugs and addiction. Childhood sexual abuse sets people up for multiple mental health issues later in life.

Childhood Sexual Abuse

The sexual abuse of a child is a devastating crime. It tears apart families, disrupts normal childhood development, and can be self-perpetuating from generation to generation. Involving a child in any sort of sexual act is child sexual abuse, and many of these cases are serial, lasting for months or even years.

child abuse crime

Sexual abuse often goes unreported, so the statistics vary greatly and are not completely reliable. Even one case of childhood sexual abuse is too many, but these statistics show the prevalence of child sexual abuse in this country:

  • About 8 million teenagers have suffered sexual abuse
  • Approximately 1 out of every 6 boys are sexually abused before they turn 18
  • Girls under the age of 18 are sexually abused at a rate of 1 in 4
  • Almost 70 percent of teenage victims are abused in their home or the home of someone they know
  • 20 percent of all abuse victims are under eight years old
  • 90 percent of the children who suffer sexual abuse know their abuser
  • Children are sexually assaulted at a higher rate than adults

There is no definitive profile of a child sexual abuser. They can be parents, neighbors or friends. Many are involved in adult sexual relationships and do not display a tendency toward loneliness. Some victimize children as a display of power over them, though that is not the motive in all cases. Some sexual predators are dealing with their own mental health issues. Some were victims of sexual abuse in their own childhood. Children may be easy victims for abusers because they won’t tell anyone about the abuse, but sexual assaults in general are sadly under-reported.

Effects of Childhood Sexual Abuse

Sexual abuse does severe damage in any instance, but it is especially pronounced when the victim is a child. A child who has been sexually abused suffers both physical and emotional effects. Some of the physical effects of childhood sexual assault include:

  • Difficulty walking
  • Bleeding
  • Bruising
  • Soreness
  • Broken bones
  • Sexually transmitted diseases
  • Pregnancy

The physical effects of childhood sexual abuse tend to present right away, although they may not be noticed by others and go without proper treatment. The physical wounds of sexual assault tend to resolve in a fairly short period of time. The mental and emotional effects could take much longer to develop and can last years or even decades. Some people carry these emotional wounds for the rest of their lives.

emotional wounds

Exposure to trauma is a risk factor for all sorts of mental illnesses, including addiction. Whether you were a witness to or a participant in the trauma affects the degree of damage you sustain, how long it lasts, and how difficult it is to overcome. Just like exposure to any trauma, childhood sexual abuse victims can experience a wide variety of emotional outcomes, including:


This is a built-in defense mechanism for the brain. When you are in a traumatic situation you have no control over and cannot end or escape, your brain has a way of switching off. During this dissociative time it is as if you are not there. The pain sensations, both mental and physical, are dulled, and often you are left with only vague memories of the incident. Dissociation can have lasting effects on your ability to concentrate and focus later in life.

Post-Traumatic Stress Syndrome, or PTSD

With PTSD, the brain is unable to process all of the emotions associated with a traumatic event. You can get stuck in an endless playback loop remembering the incident and feeling increasingly intense emotions each time. People with PTSD might have nightmares, severe anxiety, flashbacks and trouble controlling their emotions.

ptsd nightmares

PTSD can develop years after the incident when a sight or sound triggers the memory. Your brain may be able to ignore your emotional distress for a period of time until this trigger brings it all back. Until the emotions of the incident are fully processed, PTSD symptoms can persist.


Sadness following the incident can develop into clinical depression, either right away or years later. Depression can include:

  • Feelings of hopelessness
  • Lack of energy
  • Lack of appetite
  • Sleep pattern disturbances
  • Excessive sleeping
  • Suicidal thoughts or actions

Depression interferes with daily activities and the ability to make decisions, and can be debilitating.

Guilt and Shame

Children apply their own logic to the world around them that does not necessarily include all the facts. They understand things from their own unique perspective. Depending on what stage of cognitive development a child is in when they become the victim of sexual abuse, they may think it was a punishment for behavior.

Sexual abuse is almost always a secret, so the child has no one to take their side. We seldom speak openly about assault when we do talk about it, especially with children, so the victims’ ideas about their own culpability might never be challenged.

Intimacy Issues

A lot of our relationship behaviors are based on experience. When someone close to you, in your family perhaps, breaks your trust by assaulting you, the defenses you put up for future protection tend to last. If your first sexual experience is an assault before you are even old enough to understand what is happening, intimacy takes on a scary and negative connotation. It can be very difficult for children who were sexually victimized to become loving, trusting adults.

Low Self-Esteem

Someone who sexually abuses a child may use the power of negative messages to control that child and get what they want. Children are especially vulnerable to criticism because they are still developing their sense of self. They tend to internalize these messages more than adults, who have the power to argue or say no. The perpetrator of your assault may convince a child they deserved such poor treatment, and even if those were not the perpetrator’s words, their actions make the child feel they are not worthy of respect.

Eating Disorders

People develop eating disorders as a means of gaining control over themselves and their lives. These disorders can also grow out of extreme negative body image, a part of low self-esteem. Eating disorders are more likely for people who were victims of childhood sexual assault. The incident often leaves them feeling ugly or dirty, and begins a negative relationship with their bodies.

eating disorders

Childhood sexual abuse is considered a traumatic experience, and the long-term effects can be different for different victims. There is no one pattern of results that can be established by looking at the research, partly because there are variables such as age and health prior to the incident.

The time it takes to fully develop any resulting injuries and recover from them varies greatly for each victim, as well. Some get help and are able to move past the assault while others struggle for years to process their emotions and build a healthy life for themselves. For some, the emotional injuries do not present until decades after the incident, and they have a lot of unraveling to do to get to the core of their disorder.

Addiction Risk Factors

While addiction is not completely understood, yet, there are some documented risk factors. Based on cases of addiction, experts have isolated some conditions that are likely to lead to addiction. The risk factors for children and teens include:

  • Peer substance abuse
  • Poverty
  • Access to drugs
  • Lack of parental supervision
  • Aggressive behavior

A person can develop an addiction at any age, though. These are some of the risk factors for adults:

Family History

There is a genetic component to addiction. Although the right genetics are not required for a person to become an addict, having a family history of addiction does tend to predispose one to addiction. Family history can also play into the environmental causes of addiction. If you were raised in a family where drugs were used and maybe even considered part of normal behavior, you are more likely to develop the habit regardless of your DNA.

family drug use

Mental Illness

A mental illness does not have to be severe for you to be at risk for developing an addiction. Attention deficit disorder, depression, obsessive compulsive disorder, and several other mental illnesses are risk factors for addiction. People suffering from mental illnesses are more likely to try to self medicate to relieve their symptoms, and often addictive medications are used to treat these diseases.

Peer Pressure

You might think of peer pressure as something teenagers are subject to, but it can have an effect on adults, as well. “Keeping up with the Joneses” is not always about money or status. There are many reasons adults conform to the actions of their peer group. The desire to be liked or to be included can end up introducing you to drugs, and then habit and addiction take over.


Negative emotions are difficult to live with, especially for a long period of time. For some, drugs become a coping mechanism. Once the drug habit starts, addiction is highly likely.

Age of Consumption

People who begin using drugs earlier in life have a higher risk of addiction.


The more we learn about the human brain, the more we understand how devastating stress can be. For those recovering from addiction, stress is the number one relapse trigger. It is also a huge risk factor in initially developing an addiction. Drugs and alcohol are often seen as a temporary escape mechanism from daily stress or the acute stress of an unpleasant situation.

Addiction risk factors are conditions that exist before the addiction starts. In some cases, they may be used to predict, and possibly avoid, a potential addiction. These risk factors also help us better understand how addiction develops and how it is related to other conditions and incidents in life.

Childhood Sexual Abuse and Addiction

Childhood sexual abuse can create many of addiction risk factors. Victims of childhood sexual abuse who use drugs tend to do so at an earlier age than others. Many of them are looking for a mental escape from the emotional pain they feel. Some live in households where drugs and alcohol are readily accessible and accepted.

The rate of substance abuse among teenagers who have a history of sexual abuse is three or four times greater than that of other teens, according to Darkness to Light. These teenagers are also more likely to abuse drugs than alcohol and begin at an earlier age. The average age for new drug users in this age group is 15.1 years. The average teen with a history of sexual abuse begins to use drugs at 14.4 years old.

teenage substance abuse

Victims of sexual assault tend to feel greater loneliness than others. They often do not report the assault and are stuck with this terrible secret they feel they cannot share. That combined with the fact that they are likely to develop close friendships after the assault increases and prolongs their sense of loneliness.

Mental illnesses such as depression are more common among victims of sexual abuse, another risk factor for addiction. The inability to deal with emotions stemming from the abuse, especially at such a young age, can lead to PTSD and other mental illnesses.

ptsd and anxiety

PTSD, anxiety disorders, depression and suicide are more likely for children of sexual abuse than others. The dysfunction and distress of these situations often lasts long after the incident. Victims of sexual abuse are more likely to engage in risk-taking behaviors and develop behavior problems, displaying aggression and non-compliance.

Eating disorders and obesity are more common among women who survived childhood sexual abuse. These women are four times more likely to develop eating disorders between the ages of 20 and 24 than their non-abused peers. By the time they reach middle age, female survivors of childhood sexual abuse are twice as likely to be obese.

childhood peers

People with eating disorders are five times more likely to abuse drugs and alcohol than the general population. Current research estimates suggest at least 50% of people suffering from eating disorders are also addicted to one or more substances.

A Closer Breakdown of Childhood Sexual Abuse

According to a study by the National Institute on Drug Addiction (NIDA), women who survived childhood sexual abuse develop drug dependency at a three times higher rate than their non-abused peers. The study further breaks down the type of abuse experienced and correlates them with specific adult outcomes.

This chart shows the increased likelihood of drug addiction and other mental illnesses based on the type of sexual assault in childhood:

Drug Dependence Alcohol Dependence Depression Anxiety Multiple Disorders
 Nongenital 2.83 2.42 1.37 1.48 1.61
 Intercourse 5.70 4.01 3.14 2.94 5.47
 Any Sexual Abuse 3.09 2.80 1.93 1.89 2.58


Women who experienced sexual abuse involving intercourse as children are 5.70 times more likely to develop a drug addiction than women who were not abused. They are 4.01 times more likely to become addicted to alcohol and 5.47 times more likely to develop multiple mental disorders.

Getting Help

Multiple mental disorders, including addiction, occurring at the same time requires specialized treatment. It is not unusual for a survivor of childhood sexual abuse to end up dealing with co-occurring mental illnesses. When seeking treatment for addiction, you need to keep this in mind, because not all recovery programs can handle a dual diagnosis.

When you are ready to seek help with your addiction, you will not need a professional diagnosis to tell you about your addiction. Other mental disorders, however, require a professional diagnosis, and providing that while you are addicted to drugs can be difficult.

Many times, someone presents to a recovery program with addiction and then later discovers one or more underlying mental illnesses. Sometimes it takes time to understand the layers of mental distress. Addiction recovery can be like peeling an onion. You have to remove one layer to see what is underneath it. When you discover you are dealing with more than one disorder, you want to be in a program that has experience treating co-occurring conditions.

Although your mental illnesses might be revealed one at a time, it is important to treat them simultaneously. The old theory for dealing with the addiction first and worrying about everything else later has been disproven. Sobriety is no longer a pre-requisite to mental health treatment programs. What practitioners found was that a lasting recovery from addiction could not be obtained until the underlying conditions were addressed. Since addiction and other mental illnesses are intertwined, their treatment needs to be woven together as well.

Find a Program With Other Women Who Understand Substance Abuse and Child Sexual Abuse

Addressing the trauma of childhood sexual abuse in the context of addiction treatment is necessary, then, for a positive outcome. This can be tricky because childhood sexual abuse is a very sensitive topic. Many victims have withheld their stories for years and find it difficult to even think about, let alone say them out loud. Despite some education efforts from the psychology community, the public perception of sexual abuse victims is still stigmatized.

For this reason, finding a female-only recovery program is key for women suffering from addiction and childhood sexual abuse. Because of the nature of their trauma, these survivors often have issues with intimacy and sexual behavior. Even discussing anything sexual in front of men can be impossible, and an open discussion in therapy groups is required to make progress with this treatment modality.

female only recovery

Voyage Journey Pure is a women’s-only addiction recovery facility that offers treatment for dual diagnosis, as well. We provide a safe, welcoming environment for women to recover and get their lives back. Childhood sexual abuse and resulting mental health struggles, including addiction, are a far more common occurrence than you realized. At Voyage Journey Pure, you are not alone.

Our experienced, caring staff is here to guide you on your path to healing with integrated services that address every part of you. Your needs direct our treatment; you are the center of our efforts. Our holistic approach to healing includes nutrition, exercise and spirituality in a relaxing home environment.

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