Abortion and Substance Abuse Link Often Overlooked, Women's Health Review Reports

David C. Reardon
Elliot Institute
January 20, 2005
Reproduced with Permission

A new research review published in Current Women's Health Reviews highlights the growing body of evidence that abortion is linked with increased rates of substance abuse among women.

Substance abuse has increased in the past three decades in the United States, but author Priscilla Coleman, a researcher and professor of Human Development and Family Studies at Bowling Green State University, notes that "awareness of female substance abuse as an emerging public health concern is of relatively recent origin."

According to the article, rates of alcohol dependence among women are now comparable to that of men, and "drug dependence has increased steadily among girls and women in recent years and for some drugs, the increases have exceeded the increases among boys and men." Although smoking rates among both sexes have decreased, the decline in smoking rates among women tapered off in the 1990's, while it increased among adolescent girls during that same period.

Studies of substance abuse among women show that they are more inclined than men to begin abusing drugs, alcohol, and tobacco as a way of coping with traumatic life events, including physical or sexual abuse, illness, and family problems.

Women who abuse substances are also less likely than men to seek treatment and more likely to be involved in an abusive relationship; to suffer alcohol-related diseases or death; to struggle with feelings of guilt, self-blame, and low self-esteem over their substance abuse; and to experience more depression, anxiety, and symptoms of post-traumatic stress disorder (PTSD).

"It is clear that women who abuse substances are more likely to have suffered from multiple past and current challenging life situations and there is emerging evidence that women use substances as a means of coping more frequently than men," Coleman wrote.

Colman noted that several recent studies have suggested an association between having an abortion and using or abusing drugs, alcohol and tobacco. In a number of studies have shown women who have abortions are two to five times more likely to be at risk of subsequent substance use compared to women who have not had abortions. Other studies have found that women with a history of abortion are subsequently at increased risk for depression, generalized anxiety disorder, suicidal tendencies, poor bonding with and parenting of later children, and psychiatric hospitalization.

Dr. David Reardon, a post-abortion expert and director of the Elliot Institute research organization, said that there are at least 21 published studies have found a link between induced abortion and substance abuse.

Reardon served as lead author on several studies on abortion and substance abuse including a 2004 study that was the first to compare substance abuse rates among women with unintended first pregnancies and also collaborated with Coleman on two studies finding that women who had undergone an abortion were more likely to engage in substance abuse during a subsequent pregnancy.

"Many women who have experienced abortion have unresolved emotional issues related to their abortion," he said. "Substance abuse can provide an easily accessible way to self-medicate their pain and numb their emotions. Unfortunately, however, substance abuse only leads to further difficulties both in terms of their own well-being and problems in their families and other relationships and can lead to a further breakdown in mental health."

Coleman noted that risk factors may be shared both by women who abort and those who engage in substance abuse and said that researchers need to focus on identifying which variables are more likely to lead a woman to have an abortion. She called for more qualitative, interview-based research with both women and others in their lives who may have been involved in the abortion decision.

"Due to a variety of political, social, and ideological factors, the topic of induced abortion does not seem to have received the focused research attention it deserves. . . ." she wrote. "In the interest of the millions of women who annually undergo one of the most common surgical procedures available in the United States and elsewhere in the world, more substantive, well-controlled research should be a priority."

Both Coleman and Reardon encourage greater awareness of link between abortion and substance abuse among abortion providers, health care professionals, substance abuse counselors, and others who work with women. They believe substance abuse counselors should ask women seeking treatment about their reproductive history in order to "give women permission" to talk about unresolved abortion grief.

Coleman said that while many mental health professionals are open about encouraging women who have suffered miscarriage to express their emotions as a way to foster healing, abortion is often not treated the same way. This failure to address abortion may be due to either fear of probing a sensitive personal issue or to an assumption that women won't experience any emotional conflicts over a medical procedure they requested.

"If treatment for substance abuse or other mental health problems fails to address underlying factors such as abortion, the treatment may be ineffective and women are likely to continue to turn to substances such as drugs or alcohol to cope," Reardon said. "If mental health professionals are truly serious about addressing this public health concern, they need to gain a greater understanding of this issue and provide women with the resources to resolve their past abortions."