Correlates of Crack Abuse Among Drug-Using Incarcerated Women: Psychological Trauma, Social Support, and Coping Behavior

Abstract

This investigation examines the relationship between psychological trauma and crack abuse among 158 women with a recent history of drug use who were incarcerated in a New York City jail facility. Interviewers obtained data on demographics, drug use, psychological trauma history, criminal history, social support, and coping behavior variables. Three-fourths of the total sample had used crack three or more times a week for a month in the past; a quarter had used other drugs, predominantly heroin, three or more times a week for a month in the past. Multiple logistic regression analysis was used to assess the association between adult psychological trauma variables (loss of custody of youngest child and lived in streets prior to arrest) and regular crack use in three sequential models. After adjusting for social support, coping behavior, demographics, and criminal history variables, women who had lost custody of their youngest child were 3.3 times more likely to be regular crack uses. Women who demonstrated more negative coping behavior and perceived themselves as having less emotional support were also more likely to be regular crack users. The association between childhood traumas (i.e., childhood sexual abuse, childhood physical abuse, parental alcohol abuse) and regular crack use was also assessed using multiple logistic regression; however, no significant associations were found between these childhood psychological traumas and regular crack use in both the unadjusted and adjusted models. Study findings underscore the importance of assessing environmental, interpersonal, and intrapersonal factors in tailoring treatment strategies for users of crack and other drugs.

Women Behind Bars: Health Needs of Inmates in a County Jail

“…5 More than 40% of the women in our study reported ever using heroin, compared with 30% among female detainees in a New York city jail. 4 Finally, more than half of the participants in our study reported ever using intravenous drugs, more than twice the proportion reported by Richie and Johnson among incarcerated women in a New York city jail.…”

“…[3][4][5] Health risk behaviors were frequently reported among our population. Nearly threequarters of the inmates were smokers, more than twothirds reported ever being homeless, one-fifth reported having had five or more sex partners during the previous year, and close to half reported having ever traded sex for money or drugs.…”

“…[3][4][5][6] Women in jail frequently report limited access to health care prior to incarceration, a history of homelessness, and participation in high-risk behavior such as engaging in unprotected intercourse and trading sex for money or drugs. 3 Information regarding the health status of female inmates could be used in designing services for this high-risk and underserved population.…”

Psychosocial predictors of current drug use, drug problems, and physical drug dependence in homeless women

“…In addition, investigators might examine the independent contributions of deficient coping skills, lack of emotional social support, and psychological pathology on drug use behaviors. Collectively, our findings underscore the importance of assessing environmental, interpersonal, and intrapersonal factors in tailoring efficacious treatment strategies for homeless women, characterized with physical drug dependence and psychological trauma (e.g., El-Bassel et al, 1996). Studying homeless women with mental health and/or drug disorders prospectively will provide much needed information on the life events that precede episodes of homelessness, as well as data on the circumstances that facilitate the successful transition to becoming domiciled (Levine & Huebner, 1991).…”

“…However, several empirical studies (El-Bassel et al, 1996;Rhoads, 1983) have demonstrated significant findings regarding coping strategies used by either drug abusing or incarcerated women. One relevant study was conducted by Nyamathi, Stein, and Brecht (1995), who found that homeless women tend to utilize avoidant vs. active coping strategies, and that drug use was predicted by avoidant coping strategies.…”