Maltreated children are three times more likely to develop substance use disorders in adulthood

A new study published in the scientific journal Addiction has found that people who are maltreated as children may be three times more likely to be admitted to hospital for alcohol and substance use disorders by the age of 40, compared with those who are not maltreated.

The study used data from over 6,000 children born at the Mater Mothers Hospital, Brisbane, Australia between 1981 and 1983.  Ten percent of those children (609 children) had at least one child maltreatment notification (reported or substantiated) up to 15 years of age. Compared with the rest of the children, those 609 children were 2.86 times more likely to be admitted to a hospital for an alcohol use disorder and 3.34 times more likely to be admitted for a substance use disorder.  The likelihood for hospital admission was over three times higher among people who had more than two agency-reported maltreatment notifications for both alcohol use disorders and substance use disorders.

Maltreatment was defined as ‘reported’ when a person’s childhood history included agency-reported notification(s) of maltreatment.  Child protective services upgraded maltreatment to ‘substantiated’ in cases with reasonable cause to believe the child had been, was being, or was likely to be abused or neglected. 

The study also subdivided maltreatment in childhood into physical abuse, sexual abuse, emotional abuse, and neglect.  The likelihood of hospital admission for an alcohol use disorder was highest (3.48 times more likely) for people who had substantiated notifications for sexual abuse before 16 years of age.  The likelihood of hospital admission for a substance use disorder was highest (3.10 times more likely) for people with agency-reported notifications for emotional abuse before 16 years of age.

Lead author Dr Claudia Bull, of the Queensland Centre for Mental Health Research, says “Most of the previous research into childhood adversity and alcohol and substance use disorders has focussed on physical and sexual abuse.  We particularly wanted to know whether emotional abuse and neglect are as strongly associated with subsequent alcohol and substance use disorders.  As we suspected, the odds of hospital admission for alcohol and substance use disorders are comparable across all subtypes of abuse and neglect in childhood.”

Additional findings from this study (in each case, ‘childhood’ means under the age of 16): 

The likelihood of hospital admission for alcohol use disorder was:

• 2.88 times higher for substantiated notifications of childhood neglect
• 2.87 times higher for substantiated notifications of childhood emotional abuse
• 2.71 times higher for substantiated notifications of childhood physical abuse. 

The likelihood of hospital admission for a substance use disorder was:

• 3.10 times higher for substantiated notifications of childhood neglect
• 2.85 times higher for substantiated notifications of childhood physical abuse
• 2.52 times higher for substantiated notifications of childhood sexual abuse
• 2.47 times higher for substantiated notifications of childhood emotional abuse.

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For editors:

This paper is Open Access on the Wiley Online Library: https://onlinelibrary.wiley.com/doi/10.1111/add.16479), or you may request a copy from Jean O’Reilly, Editorial Manager, Addiction, jean@addictionjournal.org.

To speak with lead author Dr Claudia Bull, please contact her at the University of Queensland by email (claudia.bull@uq.edu.au).  Dr Bull is a Research Fellow with the Queensland Centre for Mental Health Research (QCMHR) and the ALIVE National Centre for Mental Health Research Translation at The University of Queensland.

Full citation for article: Bull C, Trott M, Najman JM, Arnautovska U, Siskind D, Warren N, and Kisely S. Associations between child maltreatment and hospital admissions for alcohol and other substance use related disorders up to 40 years of age: Results from the Childhood Adversity and Lifetime Morbidity study. Addiction. 2024. DOI: 10.1111/add.16479.

Primary funding: Research supported by Metro South Health Research Support Scheme (grant number RSS_2022_002). Claudia Bull was funded by an NHMRC Special Initiative in Mental Health Grant (APP2002047).

Declaration of interests: None.

Addiction is a monthly international scientific journal publishing peer-reviewed research reports on alcohol, substances, tobacco, gambling, editorials, and other debate pieces. Owned by the Society for the Study of Addiction, it has been in continuous publication since 1884.