Research on homeless and runaway adolescents has shown that this population is at high risk for illicit drug use. Though sexual abuse has been widely considered in the etiology of illicit drug use, we know less about how early sexual abuse affects young people's decisions to run away, to use drugs, and to engage in other deviant behavior on the streets. Based on interviews with 361 female homeless and runaway adolescents in four midwestern states, the current study revealed a high prevalence of drug use, especially use of cocaine among youths with sexual abuse histories. Path analyses showed that early sexual abuse indirectly affected drug use on the streets via running away at an earlier age, spending more time on the street, and use of deviant strategies to survive (e.g., affiliation with deviant peers, trading sex, and use of nonsexual deviant subsistence strategies).Research on homeless and runaway adolescents has shown that this population is at high risk for illicit drug use (such as marijuana, speed, LSD, cocaine, inhalants, and mushrooms), and other deviant behavior (Greenblatt & Robertson, 1993;Hagan & McCarthy, 1997; Kipke, Montgomery, & Mackenzie, 1993; Koopman, Rosario, & Rotheram-Borus, 1994; Whitbeck & Hoyt, 1999). Compared with the general adolescent population, rates 1 Xiaojin Chen, Ph.D., is an assistant professor in sociology at Tulane University in New Orleans, Louisiana. His current research interests include sociological methodology and deviance among homeless and runaway adolescents. Kimberly A. Tyler, Ph.D., is an assistant professor in sociology at the University of Nebraska-Lincoln. Her research interests include sexual risk taking behaviors, sexual abuse, and sexual victimization among homeless and runaway adolescents. Les B. Whitbeck is professor of sociology at the University of Nebraska-Lincoln. His research focus is adolescent risk and resilience. He is conducting a longitudinal study of homelessness and runaway adolescents. Dan R. Hoyt is a professor of sociology and head of the Bureau of Social Research at the University of NebraskaLincoln. His current research focuses on risk, deviance, and mental health among high risk populations. 34 (2004) of drug use among homeless and runaway adolescents have been found to be substantially higher (Windle, 1989; Yates, Mackenzie, Pennbridge, & Cohen, 1988). For example, Stiffman, Earls, Powell, and Robins (1987) reported the rate of drug use among homeless groups to be five times higher than their home-based peers (Stiffman et al.) High rates of early childhood sexual abuse have also been found among homeless and runaway adolescents (McCormack, Janus, & Burgess, 1986; Silbert & Pines, 1981; Tyler, Hoyt, Whitbeck, & Cauce, 2001). Sexual abuse has been widely considered in the etiology of illicit drug use among both the general population and among homeless and runaway adolescents (Finkelhor, Hotaling, Lewis, & Smith, 1990; Rotheram-Borus et al., 1992;Widom & Ames, 1994). Compared with other coping strategies, self-medication ...