Childhood Adversities and Substance Misuse Among the Incarcerated: Implications for Treatment and Practice in Correctional Settings

ABSTRACT

Background : Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. Objective: To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Methods: Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Results: Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Conclusions: Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.

KEYWORDS:

• Substance misuse
• injection drug use
• corrections
• inmates
• women

Declaration of interest

The author report no conflict of interest. The author alone is responsible for the content and writing of the article.

Funding

This work was supported by the National Institute on Drug Abuse [Grant number 1T32DA037801-01].

Notes

1 Questions included: (1) getting into situations while using drugs that increased the chances of getting hurt; (2) having arguments under the influence of drugs; (3) losing a job because of drug use; (4) having job/school trouble because of drug use; (5) getting arrested or held at a police station because of drug use; (6) getting into a physical fight while using drugs; (7) using drugs in larger amounts for longer periods of time than intended; (8) wanting or trying to cut down on drug use but could not; (9) spending a lot of time getting and using drugs; (10) having trouble doing important activities; (11) giving up activities in favor of using drugs; (12) using drugs even though it caused emotional problems; (13) using drugs even though it caused personal problems; (14) finding that the usual amount of drugs had less of effect; (15) experiencing withdrawal; and (16) using drugs to deal with bad after-effects.

2 Question items included: (1) getting into situations while drinking that increased the likelihood of getting hurt; (2) having arguments while drinking; (3) losing a job because of drinking; (4) having trouble in school or job because of drinking; (5) getting arrested or held at a police station because of drinking; (6) getting into a physical fight while drinking; (7) drink for longer time periods than intended; (8) drinking keep you from going to school or caring for children; (9) continuing to drink even though it was causing problems with family friends or work; (10) continuing to drink even though it was causing physical problems; (11) continuing to drink even though it was causing emotional problems; (12) having to drink more to get the desired effect; (13) experiencing alcohol withdrawal (14) self-medicating to deal with bad after-effects of drinking.

3 Results for other control variables are available upon request.