Childhood Trauma and Substance Abuse in Female Offenders

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Substance abuse is one of the factors related to female offender’s pathway into the criminal justice system (CJS), it has been correlated with the after-math of childhood abuse and the repeated involvement in crime (Bloom et al, 2003). Vast numbers of women in prison have been arrested for drug offences or have reported to have a drug abuse problem (Henderson, 1998). In the UK the average percentage of women who are in custody that have been reported to have a substance misuse stands at 49%, which is considerably higher than 29% of men that go onto require clinical detoxification (Light et al, 2013). The following chapter will explore the link between childhood trauma, substance abuse and crime amongst female offenders. Firstly this chapter will aim to explain the nature of crimes related to drug use and potential gender differences. Following, a review of the self-medication hypothesis and the relationship of post-traumatic stress disorder (PTSD) and addiction. Further on to explore the correlation of childhood trauma, alcohol dependence, and the socioeconomic impacts which subsequently may lead a number of women to sex crimes. The last section of this chapter will cover the recidivism rates of female offenders.

Firstly we must define what a substance is, it is ‘’any a psychoactive compound with the potential to cause health and social problems, including addiction. These substances may be legal (e.g. alcohol and tobacco); illegal (e.g. heroin and cocaine) or controlled for use by licensed prescribers for medical purposes such as hydrocodone or oxycodone’’ (McLellan, 2017, p.112). Furthermore, substance use and the association to crime is tied by the following ideas; either a criminal way of life may enable involvement with drugs or an addiction to drugs then leads to criminal activity to pay for further drug use (South, 2002).

For female offenders, drug related crime is most often non-violent involving of shop-lifting, theft, burglary or prostitution. Despite drug related offences being also a cause for men’s involvement with the CJS, men’s association or path to imprisonment is commonly through violent crimes. Henderson for instance, stated that women prisoners are more likely to have used heroin and cocaine than incarcerated men, to have used them more frequently prior imprisonment, to have taken drugs intravenously and to test HIV positive (1998). Research moreover suggests that there are also differences of how men and women react to trauma. Men may express their negative feelings through violence but women are more likely of using drugs to cope from previous abuse due to internalising those feelings (McClellan et al, 1997). Goldstein, et al (1991) have put forward that when violence among women occurs, and they are drug users, then it is commonly domestic disputes when comparing to male drug users. As stated by Stuart and Brice-Baker (2004) drug using women were six times more likely to be arrested than non-drug using women, in comparison to male drug users who were three times more likely to be arrested than non-drug using males. This finding suggests that there is a closer connection between drug use and crime for female offenders than men, even though research on this issue is limited. Incarcerated women have also emphasised that their entrance into drug trafficking and the CJS was influenced by their male partners. However in order to not perceive it as an exclusive reason, research on women drug sellers and traffickers clashes with this claim, and finds that men are not always the main cause of women’s entrance into drug use and the drug market economy. Maher stated that women have also displayed autonomous behaviour entering the drug market and have rejected the label of victims (Maher, 1997).

Moreover, a major study of over 34,500 adults regarding the relationship between substance abuse and childhood trauma was conducted by Afifi et al (2012) in the US. Males and females were recruited for Afifi et al’s study with five types of childhood victimisation researched. Consisting of sexual, emotional, physical abuse and emotional and physical neglect which was found to have a strong relationship to substance abuse and to have an increased risk of it being a lifetime issue to deal with. Evidence additionally indicates that adolescents who have experienced childhood adversity develop risk taking behaviour and an increased risk of engaging in substance use compared to youth in the general population (Brown and Shillington, 2017). Histories of childhood trauma and anxiety disorders including post-traumatic stress disorder (PTSD) has consistent indications of the use of substances as a means of dealing with physical and emotional painful feelings (Hien et al, 2005).

The self-medication hypothesis of addictive disorders could be an explanation to the link of ACE’s and substance use. According to Khantzian (1997) individuals by using drugs relieve painful past experiences and feelings, thus associating drug use with improved states of well-being. Drugs almost become as a means of self-medication to overlook negative relationships and low self-esteem, creating a sensation of being in control of undesirable emotions consequently creating a distressing affect which is the main stimulus for substance use leading towards addiction. The self-medication hypothesis can be reflected to the strain theory of crime (Merton, 1968; Agnew, 2001) as the strain may lead individuals to ease the negative effects of anger and disappointment externalising their emotions by the use of drugs. Bowles et al, similarly indicated drug use by female offenders is somehow an approach or a reaction towards relationships, burdens, family dynamics and past experiences (2012). The participants in the study by Bowles et al (2012) expressed how challenging it was to change the traumatic feelings they had which resulted to addiction, furthermore made employment hard and consequently pushing some to illegal means in order to support their habit. Asberg and Renk (2012) in a sample of over 100 female prisoners in a US correctional institution, similarly recognised the effects of childhood sexual abuse and trauma symptoms related to substance use mediated by coping. This suggests that it is the motivation for substance use which might drive the relationship between abuse and harmful outcomes, such as imprisonment.

Edwards and Gross (1976) study was a substantial step in developing the concept of dependence. Having a dependence condition consists of a cluster of physiological, behavioural and cognitive phenomena and these components have been incorporated in the internationally-used criteria for diagnosis of alcohol dependence in the DSM-IV (American Psychiatric Association, 2000). Adlaf, Begin and Sawka (2005) similarly argue that developing alcohol dependence is a result of a combination of physiological, cultural, environmental and psychological factors. Distinguishing exactly when a person becomes dependent on a substance is challenging as there is a continuum from initial contact with the drug to a state of addiction. Unless early intervention occurs, the level of addiction may escalate towards severe dependence with mental, physical and socioeconomic consequences. Alcohol dependence is most commonly characterised by a pattern of alcohol use, compulsion, preoccupation and relapse (Jaffe, 1983). To illustrate, Schuck and Widom (2001) found the underlying relationship between alcohol dependence and childhood victimisation in adult women to be predisposed by depression thus using alcohol to cope. Abused women who experienced sexual abuse as children in a research by Ullman and colleagues (2013) similarly found the association of trauma and substance use as a means of coping lifetime exposure to interpersonal and non-interpersonal trauma. Alcohol misuse was yet again mediated by PTSD symptoms and in part for other drugs.

Gilfus (1992) in one of the first qualitative studies captured mechanisms underpinning the interrelationship of trauma, substance misuse and offending between twenty female prisoners aged from 20 to 41. The first delinquent act for 13 of the individuals was running away from home which eventually lead to theft out of rough living conditions and drug use. Fifteen of the participants had an injecting drug addiction. The majority of who expressed that their motives for initially experimenting with drugs and alcohol was “wanting to be obliterated’’, to gain self-confidence, coping with working as a prostitute and to be accepted by peers. Prostitution was primarily the main reason for the shift from experimental use to addiction of cocaine and opiates after starting illegal acts. Lastly, Gilfus noted that the consequences were due to a pattern of shifting from victim, to survivor, to offender and the patterns that followed after abusive childhoods comprised of recurring victimisation, addiction, prostitution and harmful relations with violent men involved in criminal activities.

Furthermore, Grella, Stein and Greenwell (2005) observed 440 substance abusing women offenders in the US aiming to understand the relationship of childhood traumatic events and later adult indicators of criminality and psychological distress. Their results found that looked after children or adoptive children who were abused by their caregivers were associated to engaging in sexual crimes such as prostitution and early experiences of traumatic events of assaults were related to violent offences. Nevertheless, despite childhood sexual abuse being directly linked to adult criminal behaviour, substance abuse was not considered as being directly related to crime. Whereas those two factors correlated that is when it resulted to crime.

In addition, prostitution as mentioned above has in the recent decades been associated with crack and cocaine. Street based crack use transformed the nature of prostitution according to Maher and Curtis (1992), as there was an increase of sexual exploitation and lower prices of street-based sexual exchanges for drugs or money with a concurrent increase in violent victimisation of women (Maher and Curtis, 1992; Ratner, 1993). Thus, female association to both drug dealing and sex trade has been assumed to have increased with the spread of crack and cocaine use in recent years. A feminist explanation however would reflect that prostitution and drug use could be a further understanding of the economic and other coercive pressures that often force women’s consent to sexual acts in prostitution (Jeffreys 1997).

Besides substance abuse being a means of coping from trauma, and the possible pathway to crime and prostitution, Stuart and Brice-Baker (2004) moreover found that female prisoners with a history of drug offences had higher recidivism rates. The rates were similar to those convicted of property offences rather than those convicted of violent or other offences. Furthermore, in addition to the 30 percent of the sample that were imprisoned for drug offences, a further 18 percent said that their crime was committed to obtain money for drugs, although the original crime was not itself drug-related. High rates of addiction are found among incarcerated women and women’s rising rates of incarceration are attributed primarily to aggressive drug enforcement and heavy sentences imposed for drug convictions (Carlen, 1998). Carlen furthermore argues that the perceived increased drug use and crime is not necessarily a gendered issue nor that women are more engaged in drugs. Rather, the ‘war on drugs’ by politicians and the changes of stricter drug policies have contributed to a greater number of female convictions (1998).

On the whole, and concluding this chapter drug use by female offenders is by one way or another an approach and a reaction towards their past. Relationship burdens, family dynamics and past experiences allows us to believe that their motives for initially experimenting with drugs and alcohol was wanting to be free, to gain self-confidence, coping with working as a prostitute as Gilfus (1992) notes. The self-medication hypothesis is an appropriate explanation of why traumatised women feel the need to use drugs. Undoubtedly the findings support feminist pathway research, which states that childhood victimization is generally present in female offender’s lives and that a drug pathway with childhood abuse and PTSD has proved to be significant among criminal justice-involved women. It has been a common theme throughout the above chapter that the effects of childhood trauma has long lasting effects to female offenders, and the nature of the crimes are typically not violent but more so linked to theft and burglary in order to support themselves or their male counterparts either economically or for their addiction. Without identifying the factors influencing women’s engagement in criminal behaviour and substance use, the possible protective factors that may lessen these high-risk chances of addiction, crime and recidivism which are important opportunities to intervene, may be missed.

Green, Miranda, Daroowalla, and Siddique (2005) found that 62% of 100 female inmate sample report exposure to childhood trauma and 90 % trauma reporting at least one incidence of interpersonal trauma. Despite being it recognised that a history of abuse and family-related problems are common issues among female offenders, many correctional systems do not screen for childhood or adult abuse when determining possible therapeutic interventions order to reduce recidivism (Morash, Bynum and Koons, 1998). Hence the next chapter will focus on female offenders and the further effects of incarceration.

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