Rape, Trauma, and Substance Abuse

By Dorri Olds 04/03/16

When we have been terrorized through sexual assault and can't advocate for ourselves in the moment, that fight or flight energy has to go somewhere.

Are Raped Women More Likely to Become Drug Addicts Than Alcoholics?

I came across this startling statistic: Rape victims are 13.4 times more likely to have an alcohol problem and 26 times more likely to have a drug problem. At first, the stat made me feel more “normal.” I’m a rape survivor who thought of herself as more of a drug addict than alcoholic, but the more I thought about it, I felt those numbers couldn’t possibly be correct. Alcohol is legal, hence easier to get your hands on, and it’s celebrated in society. 

I tracked down the source of the claim: The National Women’s Study (NWS), a large research project funded by the National Institute on Drug Abuse (NIDA). The numbers from that study are frequently quoted by respected sites including RAINN (Rape, Abuse & Incest National Network). The date of the study was 1992! There had to be something more recent, so I kept digging.

I found neuroscientist Apryl Pooley, a recovering alcoholic, rape survivor, and author of Fortitude: A PTSD Memoir (2015). Pooley researches the effects of traumatic stress on the brain at Michigan State University. I asked what she thought about the NWS findings. 

She said, “That frequently-quoted study doesn’t include drug- and alcohol-facilitated rape, or coercive rape, which collectively includes the vast majority of rapes. And it didn’t include non-penetrative sexual assault, which we know has similar adverse consequences to penetrative assault. Among the rape victims in that study, 20.1% of them developed alcohol problems, while 7.8% of them developed drug problems. So, more of them—3 times more—were abusing alcohol compared to drugs. Most likely due to accessibility.”

Aha! Seems my hunch was right.

Pooley continued, “The reason the study found [rape survivors] were 26 times more likely to abuse drugs was because the sample population they compared them to had such a low prevalence of drug abuse (0.3%) and a bit higher (but still low) prevalence of alcohol abuse (1.5%). The comparative population was people who have never been victims of any crime and that is not a representative of the general population.”

I began to get lost with the calculations.

“For comparison,” Pooley said, “the 2013 National Survey and Drug Use and Health survey, which is a representative sample of the entire population, found the prevalence of substance abuse disorders in the United States’ 12-and-older population to be 6.6% for alcohol only, 2.6% for illicit drug only, and about 1.5% for both alcohol and drugs, and drug abuse mostly included marijuana and pain relievers—much lower rates for cocaine, heroin, and other drugs—again because of accessibility.”

Here’s where I gave up and asked Pooley to talk to me like I was a second grader.

“Okay, so the 13 times more likely to have alcohol problems versus 26 times more likely to have a drug problem aren’t referring only to rape victims. These numbers are for rape victims who develop PTSD.”

But, wait. Don’t all rape victims have PTSD? 

Pooley said no. “Rape and sexual assault and childhood sexual abuse are the types of trauma that are most likely to lead to PTSD—more than anything else aside from torture and captivity which is pretty rare. But only 30 to 50% of sexual violence victims develop PTSD and that has been replicated over and over in study after study.”

Wow! Another surprise.

Here’s some info that backs Pooley’s statements.

The surveys in NWS were in 1989 and 1990 and only forcible rapes of adults were included, which left out a large group of rape victims. Verbal coercion and drug/alcohol-facilitated rape is more common than forcible rape and this is especially true among college victims (Black et al., 2011).

Also, 75% of victims who meet the criteria for having experienced sexual assault or rape do not acknowledge that they were assaulted; thus, surveys like the NWS that directly ask about a rape or assault are often inaccurate (Cleere and Lynn, 2013).

Now I was getting it. The math isn’t always what it seems.

Next I spoke to psychotherapist and addictions specialist Paula Tropiano who said, “My perspective is from behavioral health and addiction treatment. After 20 years in this field I’ve learned about patterns. With rape, the role of shame and secrecy can be immense and, if the rape victim was drinking at the time, that can create feelings of guilt and responsibility and victims may choose to stuff these feelings down.

“Human nature says we are supposed to have control over our bodies and minds. When we have been terrorized through sexual assault and can’t advocate for ourselves in the moment, that fight or flight energy has to go somewhere. If we freeze, our central nervous system is still hyper-aroused. It’s all wound up and buzzing. Victims dissociate so they detach from feeling their emotions. The emotions are still happening, though. That disconnect leads to trying to control and regulate feelings.

“I see that a lot with young women who have many addictions, like marijuana, and a sexual component. They think they are making choices. They are normalizing that behavior. It becomes a little dicey [for the therapist]. You don’t want to judge. People have choices. But soon it becomes apparent that they aren’t making choices, they are harming themselves. My clients often normalize their substance abuse and the hyper-sexuality and don’t see that they’re involved in an addictive behavior.”

Tropiano talked about neural pathways. I think most addicts in recovery know what those are: sensory nerve cells that feed info to our brains. Without us knowing, the ol’ noggin says, “Hmm, what should I make of this data?” If the data creates anxiety, we reach for a drink or a drug to “treat” it. We are beginning to create a pathway. With repetition, the pathway becomes set. 

Think of it like walking through a field of overgrown grass. If you walk in a line repeatedly, you’ve created a path in the same way habitual behavior can create an addiction.

"Our brain has survival mechanisms meant to keep us alive in the short term," Tropiano tells The Fix. "The problem is how to dismantle the behaviors that have become habitual and created neural pathways. In my role as an assessor, I have to look into what clients are taking. I see people who have been prescribed benzodiazepines—Valium, Xanax, Klonopin—and that is obviously counter-productive. Benzodiazepines are not going to cure rape flashbacks and feelings of overwhelm. They won’t stop the brain from becoming reactivated by stress and once reactivated, those drugs don’t stop the compulsion to repeat addictive behaviors."

Therapist Bobbi Parish, who specializes in trauma recovery coaching, is also a sexual assault survivor. Her online business, Trauma Recovery University, has Twitter chats and Google Hangouts. Its 17,000 members in 55 countries are all survivors of sexual abuse. 

I asked Parish, based on her 18 years in the field of therapy, what she thought about drug abuse versus alcohol abuse among rape survivors. “One reason that survivors may prefer drugs,” Parish said, “is so they can try to control the high. When you’re drinking alcohol, that first buzzed state is where you get the feeling of euphoria and relax. But if you keep drinking, you get drunk. It’s hard to keep the constant level of alcohol in your bloodstream required for attaining euphoria. Especially when you’re at work. Carrying a flask in your back pocket is not as cool as it used to be and it’s much easier and more discreet to pop a pill.”

“There’s a mind muckery that comes from having been sexually assaulted," she continued. "Survivors don’t feel any self-worth. They often have terrible trouble with social relationships, romantic partner relationships, and may struggle with parenting. It’s easy to get prescription medication that can provide that lovely, floaty, euphoric feeling and it’s more convenient to swallow a pill than to throw back whiskey. Not too many people can justify sitting at a bar saying, 'I need this because I was raped and I feel terrible.' But it’s easy to say, 'My doctor said I have anxiety so she prescribed medication.'"

Bottom Line

Don’t believe everything you read, even when the source of information seems reliable. Author Ron DeLegge II said it best: “99 percent of all statistics only tell 49 percent of the story.” Or, you may prefer poet Criss Jami’s line, “With enough mental gymnastics, just about any fact can become misshapen in favor to one’s confirmation bias.” 

’Nuff said.

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Dorri Olds is an award-winning writer whose work has appeared in many publications including The New York Times, Marie Claire, Woman’s Day and several book anthologies. Find Dorri on Twitter, Facebook, and LinkedIn.