The association between sexual abuse and substance use in 9th-12th grade students in the United States
Abstract
Introduction and Objective. While there is a well-established link between child sexual abuse (CSA) and substance use disorders (SUDs) in adulthood, there remains a lack of research investigating substance abuse during adolescence. Our study will explore whether past sexual abuse is associated with substance use in US high schoolers in 2021. Methods. A retrospective cross-sectional study of US high schoolers was conducted using the 2021 Youth Risk Behavior Surveillance System (YRBSS). Exposure was defined as a binary variable to reflect whether students were ever physically forced to have sexual intercourse, experienced sexual violence, and or sexual dating violence. The outcome was a binary composite variable to reflect the use of any of the following substances: marijuana, synthetic marijuana, cocaine, inhalants, heroin, methamphetamine, ecstasy, illegal injection drugs, or inappropriately used prescriptions. Multiple logistic regression was used to obtain odds ratios and 95%CI while adjusting for age, sex, race, orientation, bullying, screen time, parent(s) job loss, alcohol, tobacco, or vaping use, and poor mental health. Results. The survey had 6,355 participants, with about 51% of respondents being female and 28% aged 17. The prevalence of substance use was approximately 80% among the exposed and 46% among the non-exposed. Students with a history of CSA were 4.8 times more likely to use substances than students without a history of CSA. (crude OR=4.8; 95% CI 4.0,5.7). After multivariable adjustment, students with a history of CSA were 2.2 times more likely to use substances than students without CSA (OR=2.2; 95% CI 1.7,2.9). Sexual minorities were almost twice as likely to have used substances as heterosexual students. Alcohol users were nearly three times, vape users six times, and tobacco users three times more likely to use other substances than non-users. Conclusions-Implications. We show a strong association between past sexual abuse and substance use among US high schoolers. Longitudinal studies and large-scale qualitative examinations are needed to determine the temporality of these factors, as well as the efficacy of early interventions and prevention efforts for gateway substances like alcohol, vaping, or tobacco.
Keywords
Child sexual abuse, substance use
Presentation Type
Oral Presentation
The association between sexual abuse and substance use in 9th-12th grade students in the United States
Introduction and Objective. While there is a well-established link between child sexual abuse (CSA) and substance use disorders (SUDs) in adulthood, there remains a lack of research investigating substance abuse during adolescence. Our study will explore whether past sexual abuse is associated with substance use in US high schoolers in 2021. Methods. A retrospective cross-sectional study of US high schoolers was conducted using the 2021 Youth Risk Behavior Surveillance System (YRBSS). Exposure was defined as a binary variable to reflect whether students were ever physically forced to have sexual intercourse, experienced sexual violence, and or sexual dating violence. The outcome was a binary composite variable to reflect the use of any of the following substances: marijuana, synthetic marijuana, cocaine, inhalants, heroin, methamphetamine, ecstasy, illegal injection drugs, or inappropriately used prescriptions. Multiple logistic regression was used to obtain odds ratios and 95%CI while adjusting for age, sex, race, orientation, bullying, screen time, parent(s) job loss, alcohol, tobacco, or vaping use, and poor mental health. Results. The survey had 6,355 participants, with about 51% of respondents being female and 28% aged 17. The prevalence of substance use was approximately 80% among the exposed and 46% among the non-exposed. Students with a history of CSA were 4.8 times more likely to use substances than students without a history of CSA. (crude OR=4.8; 95% CI 4.0,5.7). After multivariable adjustment, students with a history of CSA were 2.2 times more likely to use substances than students without CSA (OR=2.2; 95% CI 1.7,2.9). Sexual minorities were almost twice as likely to have used substances as heterosexual students. Alcohol users were nearly three times, vape users six times, and tobacco users three times more likely to use other substances than non-users. Conclusions-Implications. We show a strong association between past sexual abuse and substance use among US high schoolers. Longitudinal studies and large-scale qualitative examinations are needed to determine the temporality of these factors, as well as the efficacy of early interventions and prevention efforts for gateway substances like alcohol, vaping, or tobacco.