The child welfare system most commonly perceives substance abuse as causing abuse or neglect of children. However, research is also beginning to show that child abuse, particularly sexual abuse, is a common precursor of substance abuse (Dembo et al, 1997; National Research Council, 1993). The early initiation of substance use is a risk factor for addiction, and may in part represent a child's attempts to escape the unresolved emotional trauma of abuse or neglect (National Research Council, 1993). This suggests the need for improved attention to the emotional health of children in foster care, and to the need for substance abuse prevention activities focused on children involved with the child welfare system. Without intervention, the child victims we seek to protect today may become the next generation of abusive or neglectful parents.
McCauley and colleagues (1997) found that women with a history of childhood physical or sexual abuse were nearly 5 times more likely to be current users of street drugs and over twice as likely to have a history of alcohol abuse than were other women. In addition, a study of alcohol and other drug dependent persons in Iowa found that a third of dependent persons reported physical abuse as children (as compared with 11 percent in the general population), and 13 percent reported sexual abuse as children (compared with 6.3 percent in the general population) (Lutz et al, 1995).