Women, sex and substance use: chicken and egg? March 15, 2013

The risk of developing alcohol or marijuana “dependence disorders” for young people is linked to the number of sex partners they have, according to a recent article published in the Archives of Sexual Behavior.

The researchers say that alcohol and marijuana use may encourage sexual behaviour.

There’s a shocker. The reason they link multiple sex partners and later substance abuse is because they are both part of a cluster of risk-taking behaviours that happen in adolescence and young adulthood. The association in the research was stronger for women. They added that the alcohol industry encourages the view that alcohol is entertainment, and that young women are encouraged to keep up with the boys.

The study was done in New Zealand where the ads for alcohol mirror our own in their intent. Ann Dowsett Johnston in her article “Women and Alcohol: To Your Health?” published in Network magazine refers to Mike’s Hard Pink Lemonade, Smirnoff Ice Light, wines like MommyJuice and Stepping Up to the Plate, berry-flavoured vodkas, Vex Strawberry Smoothies, coolers in flavours like kiwi mango, green apple, wild grape; and alcopop, also known as the cooler, “chick beer” or “starter drinks.” Judging from the statistics of alcohol consumption for young women, the ads have been very successful.

While the Archives article also discusses anxiety and depression, what interests me is the notion of “risk-taking behaviours.”

People who lack the basics for good health tend to have risky health behaviours, like tobacco and alcohol abuse. So do people who are survivors of sexual abuse.

The researchers had taken prior mental health status into consideration in the analysis of their findings. I doubt that they would consider child sexual abuse to be a mental health disorder; but of course it can provoke mental—and even physical—disorders. The body remembers even what the mind prefers to repress. For youth accessing treatment for both addiction and mental health problems at the Toronto Centre for Addiction and Mental Health (CAMH), it is frighteningly common for them to have histories of traumatic stress as well as sexual abuse.

I met Laura (not her real name) when she was 11.  She was a student in a Grade 6 class I was teaching about puberty. In those days, I spent six hours with each Grade 5 and 6 group, so I got to know the kids pretty well. I always ended with a session on sexual abuse. I remember listening to Laura’s teachers in the staff room. They were talking about her, making remarks akin to teenage boys’ comments about high school girls with a “reputation.” After the class on sexual abuse, Laura disclosed to me that she had been gang raped at nine and had been in an alcohol daze ever since. I should have figured it out from the teachers’ remarks. Precocious sexual behaviour can be a marker of sexual abuse.

I put Laura in touch with a child protection agency. A few years later, I saw her regularly in a sexual health clinic and eventually encouraged her to go into therapy. During her adolescence, Laura still abused alcohol and other drugs and was sexually assaulted more than once. I would accompany her to the sexual assault care centre to hold her hand.

A colleague of mine at the time said there was no point in treating substance abuse unless you dealt with the root causes first. She had expertise in both, professionally and personally.

Similarly, adolescent pregnancy is not as simple as asking why teens just don’t use condoms. Health professionals can plot adolescent pregnancies on a city map and see the links with lower socio-economic status. In other words, risky behaviours do not exist in a vacuum. They are linked to basic needs: food, shelter and freedom from sexual violence and racism.

Substance use, aside from being big business, serves multiple purposes. Alcohol removes inhibitions, which makes it the most common drug used for date rape. Alcohol and other substances including tobacco are used to self medicate. Dowsett Johnston says, “the strongest predictor of late onset drinking is childhood sexual abuse.” Laura was self-medicating throughout her adolescence: she was dulling the pain of a traumatized life. While the research may show an increase in substance abuse afterhaving multiple partners, in Laura’s case—and for many women who are sexually abused as children—substance abuse came first.

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