Study: Trauma causes high levels of intergenerational substance use among Black women

Government data show that approximately 7.2 million women in the United States have substance use disorders (SUDs) and almost 20 million reported illicit substance use in the past year. New research suggests that trauma leads to high levels of intergenerational substance use among Black women, and race and gender may play a role, according to researchers from Penn State and the University of Kentucky.

"More attention is needed to better understand the needs among Black women as the relationship between trauma and SUDs may be more pronounced because of their race and gender," noted Abenaa Jones, assistant professor of human development and family studies and Ann Atherton Hertzler Early Career Professor in Health and Human Development.

In the first study of its kind, the researchers examined the effects of trauma and intergenerational substance use on substance use and child welfare outcomes among Black women. Each increase in the number of parents or grandparents with drug and/or alcohol problems was associated with 30% increased odds of women's drug use and 40% increased odds of these women having an open Child Protective Services (CPS) case with their children, according to Jones.

"On average, the women in our sample were 35 years of age," said Jones, who is also a Social Science Research Institute (SSRI) co-funded faculty member through the Consortium on Substance Use and Addiction (CSUA). "Parents and grandparents of this age group would have lived in a much different society with limited access to substance use treatments, and excessively punitive consequences for different racial and ethnic groups who use substances. Our results may reflect the ongoing consequences of these issues." 

The women included in the study were primarily Black woman who were already in the criminal justice system, either on probation or in prison. In terms of family structure, women on average had two children living with them while 18% reported homelessness in the past year. Physical abuse during childhood was reported by 21% of participants.  

The researchers found high levels of intergenerational substance use among Black women regardless of whether they were recruited for the study from the community or through involvement with the criminal justice system. They published their findings in the Journal of Substance Use and Addiction Treatment.

Women in prison reported an increased likelihood of feeling shame versus women on probation or those not involved with the criminal justice system. Similarly, regardless of criminal justice involvement, one-third of women reported witnessing physical violence in their childhood homes, but intergenerational substance use, and a history of a CPS case were more prevalent among women involved with the criminal justice system than in community-recruited women.  

"Notably, over 20% of women surveyed indicated a history of physical abuse during childhood," said researcher Christian Connell, associate professor of human development and family studies, SSRI co-fund, and the director of the Child Maltreatment Solutions Network.  

"The pervasiveness of intergenerational substance use, trauma, and experienced childhood trauma throughout the study indicates that importance of understanding the prevalence and impacts of these issues among Black women and other minority and indigenous populations. The study's findings call for multiple community-level interventions specific to criminal justice settings and substance use treatment," said Carrie Oser, Endowed DiSilvestro, professor of sociology at the University of Kentucky and the principal investigator of the grant. 

Jones noted that the interplay between SUDs and sex/gender leaves women and their children at higher odds of harmful effects due to biological and social factors.

"This could include progressing to addiction faster than men and the criminalization of substance use while pregnant," said Jones. 

Additionally, the team mentioned the importance of interventions such as strengthening self-esteem in romantic and non-romantic interpersonal relationships. Other studies noted that women have identified that strength of interpersonal relationships, self-efficacy, and self-esteem are essential factors in recovery from SUDs. Furthermore, Black women are more likely to use informal resources like family and friends, which may provide support against the impacts of racism and misogyny.  

"Our hope is that by examining the connection between intergenerational trauma and substance use, we can expand upon and target interventions to groups of people who are already understudied and underserved. And it is critical to underscore that this is a first step, but much more work is needed," said Jones.