A Review of Childhood Maltreatment and Adolescent Substance Use Relationship

Adolescence is a period of heightened exploration, emotional and physical change. During this time, engagement in risk behaviours occurs often, affecting physical, mental and social health and well-being. Risk factors can include experimentation with substances and may lead to social and legal problems, disability and accidental death. We searched CINAHL, PsycINFO, ERIC, Medline, Social Policy & Practice and PubMed to identify studies that measured child maltreatment (witnessing domestic violence, emotional maltreatment, neglect, physical and sexual abuse) and the use/abuse of substances (nicotine (cigarette smoking) alcohol and a variety of drugs) in community and school samples. Thirty-five articles comprising 31 studies met inclusion criteria. The majority of included studies identified an association, with increased risk of substance use/abuse among youth with history of child maltreatment. Physical and sexual abuse and alcohol use/abuse were most often measured. The magnitude of the association varied by type of maltreatment and type of substances: sexual abuse and (a) nicotine (odds ratio (OR) 0.9-4.2); (b) alcohol (OR 1.4-5.2) and (c) drugs (OR 1.0-8.6); physical abuse and (a) nicotine (OR 1.8-6.1); (b) alcohol (OR 0.8-8.9) and (c) drugs (OR 1.8-20.4); neglect and alcohol (OR 1.2-21.2); emotional maltreatment and (a) nicotine (OR 1.4); (b) alcohol (OR 1.5) and (c) drugs (OR 1.4); and witnessing domestic violence and (a) nicotine (OR 1.4-2.2); (b) and alcohol (OR 1.4-1.9). The results are examined and implications for research and intervention are discussed.