Drug and Alcohol Abuse after Abortion

Martha Shuping
Reproduced with Permission
Rachel Network

In a 2005 review article,1 Dr. Priscilla Coleman, Ph.D. (Associate Professor of Human Development and Family Studies of Bowling Green State University, Bowling Green, Ohio) examined the relationship between induced abortion and risk of substance abuse. She reported that since the early 1970's [when legal abortion became widely available in the United States], substance abuse has increased among girls and women. Studies show that women who have had abortions have a higher rate of drug and alcohol abuse compared to women who have not had abortions. Even more troubling is an increased rate of drug and alcohol abuse during pregnancy. Research also shows the drug and alcohol abuse occurs abuse occurs after abortion rather than before the abortion. The information which follows is drawn from Dr. Coleman's 2005 article and I acknowledge her assistance in preparing this brief summary.

• In the U.S., drug dependence among girls and women has increased steadily since the early 1970's. This was concluded based on an extensive review of the literature.2
• For some drugs, the increase in drug abuse among females has exceeded the increase among males.3
• An increase in drug and alcohol abuse among women is a special concern because substance abuse during pregnancy has been linked to poor pregnancy and birth outcomes.4,5
• Drug and alcohol abuse during the mother's pregnancy is also harmful to the child's future development and education.6,7
• Mothers with a history of previous abortion are more likely to use illegal drugs and alcohol during their next pregnancy. Compared to women who had previously given birth, women who had previously aborted were significantly more likely to use marijuana (929%), various illegal drugs (460%) and alcohol (122%) during their next pregnancy. Differences between the groups were even greater when more time had elapsed since the prior pregnancy. This U.S. study used a nationally representative, racially diverse sample, and measured substance abuse at a time when abortion-related stress is likely to be exacerbated.8
• Other studies have also shown significantly higher rates of alcohol use and illicit drugs such as cocaine, methamphetamines, and opiates among pregnant women who have aborted compared to pregnant women who have not.9,10,11,12,13
• In a study of pregnant women, there was no difference in risk of substance abuse between women who wanted the pregnancy compared to those who did not want the pregnancy. But higher rates of drug abuse during pregnancy were found in women who had a previous abortion compared to women who had no prior abortion.14 This study included 1020 women who gave birth in Washington D.C. area hospitals in 1992. Those who had a past abortion history had significantly higher risk of using marijuana (201%), crack cocaine (198%), cocaine other than crack (406%), any illegal drugs (180%), and also cigarettes (100%) during their 1992 pregnancy. There was no link between drug abuse and miscarriage or stillbirth. Comparing women who said the current pregnancy was wanted and those who said it was unwanted, there was no difference in substance abuse (except for cigarette use). Only the women who had a past abortion had the increased rate of substance during their pregnancy (other than cigarette use).
• Teen drug abusers more likely to report past abortion: Comparing teen-age drug users to non-users, more of the drug users reported an abortion in their past (33% compared to 16.3%). In this study, there was no link between drug use and becoming pregnant, and no link between drug abuse and other types of pregnancy loss (miscarriage or stillbirth).15
• Among women who had unintended first pregnancies, women who aborted, when compared to those who carried to term, were twice as likely to use marijuana and reported more frequent use of alcohol after controlling for age, race, marital status, income, education, and prior psychological well-being. This was a nationally representative sample, racially diverse sample which used data from the National Longitudinal Survey of Youth.16
• Illegal drug use (drugs than marijuana) 6.1 times higher among women with history of abortion compared to women with no history of abortion. This was found in a large study of more than 700 women in New York state..17
• Substance abuse 4.5 times higher among women with past abortions.18 Among women with no previous history of substance abuse, women who had abortions were compared to women who carried their pregnancies to term. Substance abuse was 4.5 times higher with those who aborted. Eighty-nine percent of the women reported the substance abuse started within three years of the abortion.
• Alcoholics in a detoxification center were more likely to report alcohol problems after an abortion rather than before.19
• Many other studies have shown significant associations between abortion and substance abuse.20,21,22,23

References:

1 Coleman, PK. Induced Abortion and Increased Risk of Substance Abuse: A Review of the Evidence. Current Women's Health Reviews. 2005;1:21-34. [Back]

2 Greenfield SF. Women and alcohol use disorders. Harvard Review of Psychiatry. 2002;10:76-85. [Back]

3 Pincus HA, Tanielian TL, Marcus SC, et al. Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA.1998;279:526-531. [Back]

4 Hutchings DE. The puzzle of cocaine's effects following maternal use during pregnancy. Are there reconcilable differences? Neurotoxicology and Teratology 1993;15:281-286. [Back]

5 Ondersma S J, Simpson S M, Brestan EV, et al. Prenatal drug exposure and social policy: The search for an appropriate response. Child Maltreatment: Journal of the American Professional Society on the Abuse of Children 2000;5: 93-108. [Back]

6 Streissguth AP, Barr HM, Sampson PD. Moderate prenatal alcohol exposure: Effects on child IQ and learning problems at age seven and a half years. Alcoholism, Clinical and Experimental Research 1990; 14: 662-669. [Back]

7 Streissguth AP, Barr HM, Sampson PD, et al. Prenatal alcohol and offspring development. The first fourteen years. Drug and Alcohol Dependence. 1994;36:89-99. [Back]

8 Coleman PK, Reardon DC, Rue V, Cougle J. Prior history of induced abortion in relation to substance use during subsequent pregnancies carried to term. American Journal of Obstetrics and Gynecology. 2002;187:1673-78. [Back]

9 Kuzma J, Kissinger D. Patterns of alcohol and cigarette use in pregnancy. Neurobehav Toxicol Teratol 1981;3:211-21. [Back]

10 Gladstone J, Levy M, Nulman I, et al. Characteristics of pregnant women who engage in binge alcohol consumption. CMAJ 1997;156:789-794. [Back]

11 Frank DA, Zuckerman BS, Amaro H, et al. Cocaine use during pregnancy: Prevalence and correlates. Pediatrics 1988; 82: 888-895. [Back]

12 Graham K, Koren G. Characteristics of pregnant women exposed to cocaine in Toronto between 1985 and 1990. CMAJ 1991;144:563. [Back]

13 Oro AS, Dixon, SD. Prenatal cocaine and methamphetamine exposure: maternal and neo-natal correlates. Pediatrics 1987;111:571-578. [Back]

14 Coleman PK, Reardon DC, Cougle J. Substance use among pregnant women in the context of previous reproductive loss and desire for current pregnancy. British Journal of Health Psychology. 2005; 10 (2):255-268 (14). [Back]

15 Amaro H, Zuckerman B, Cabral H. Drug use among adolescent mothers: profile of risk. Pediatrics 1989;84:144-51. [Back]

16 Reardon DC, Coleman PK, Cougle J. Substance use associated with prior history of abortion and unintended birth: A national cross sectional cohort study. American Journal of Drug and Alcohol Abuse. 2004;26:369-383. [Back]

17 Yamaguchi D, Kandel D. Drug use and other determinants of premarital pregnancy and its outcome: A dynamic analysis of competing life events. Journal of Marriage and the Family 1987; 49: 257-270. [Back]

18 Reardon DC, Ney P. Abortion and subsequent substance abuse. American Journal of Drug & Alcohol Abuse. 2000; 26: 61-75. [Back]

19 Morrissey ER, Schuckit MA. Stressful events and alcohol problems seen at a detoxification center. Journal of Studies on Alcohol 1978;39:1559-76. [Back]

20 Drower SJ, Nash ES. Therapeutic abortion on psychiatric grounds. Part I: A local study. South African Medical Journal 1978;54:604-608. [Back]

21 Houston H, Jacobson L. Overdose and termination of pregnancy: an important association? British Journal of Private Practice 1996;46:737-738. [Back]

22 Klassen AD, Wilsnack SC. Sexual experience and drinking among women in a U.S. national survey. Arch Sex Behav 1986;15:363-92. [Back]

23 Mendelson MT, Maden CB, Daling, JR. Low birth weight in relation to multiple induced abortions. American Journal of Public Health 1992;82:391-394. [Back]

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