Childhood sexual abuse and age at initiation of heroin, crack, and cocaine

Objectives: Previous studies have demonstrated that childhood sexual abuse (CSA) is associated with earlier initiation of injection drug use. We examined the relation between broader CSA definitions and age of heroin, crack, and cocaine initiation, controlling emotional and physical abuse. Methods: Linear models were used to compare age at first use among heroin, crack, and cocaine users by specific CSA variables, stratified by gender. Results: Participants (1500) were predominantly male (66%) and Black (50%). The mean age of heroin, crack, and cocaine initiation were 21, 25, and 18 respectively. Male participants who, at age ≤ 15, performed forced oral sex used heroin earlier than those who did not (19 versus 23 years old, p=0.05). Male participants who, at age ≤ 15, performed forced oral sex started heroin, crack and cocaine earlier than those who did not (19 versus 23 for heroin, p= 0.05; 20 versus 25 for crack, p= 0.01; 16 versus 19 for cocaine, p<0.05). Male participants who reported that someone five years older had performed insertive anal sex with them at age ≤ 15, used crack earlier than those who did not (age 25 versus 37, p=0.02). Women who at age ≤ 15 witnessed someone five years older masturbate, used crack earlier than those who did not (age 23 versus 32, p=0.06). Conclusion: Our results demonstrate that non-intercourse CSA events were associated to earlier age of heroin, crack and cocaine initiation. These data emphasize the need to integrate drug abuse prevention with post-victimization services for children and adolescents.