Recommended Readings

Below is a selection of key resources on the interconnections between substance use, mental health and trauma. Where possible, we have selected studies relevant to the Canadian context. All articles have been published within the past 10 years (since 2001).

The list is not meant to be exhaustive, but rather serve as an introduction and overview of key issues and perspectives. If you are interested in a more complete listing of grey and academic literature, please contact the BC Centre of Excellence for Women's Health.  For full versions of academic research articles not available on-line, we encourage you to e-mail requests for electronic reprints (e.g., text files, PDFs, faxed copies) to the lead author.

1. Amstadter, A.B., Resnick, H.S., Nugent, N.R., Acierno, R., Rheingold, A.A., Minhinnett, R. & Kilpatrick, D.G. (2009). Longitudinal trajectories of cigarette smoking following rape. Journal of Traumatic Stress, 22(2), 113-121. Research has identified that cigarette smoking increases following trauma exposure. The authors focused on increases for sexual assault victims in particular, and found that increased smoking depended on a few factors which include depression, PTSD symptoms, and being injured during the assault. The authors discuss interventions to target smoking following an experience of sexual assaualt

Link to Abstract on PubMed »

2. Back, S., Sonne, S., Killeen, T., Dansky, B., & Brady, K. (2003). Comparative profiles of women with PTSD and comorbid cocaine or alcohol dependence. The American Journal of Drug and Alcohol Abuse, 29(1), 169-189 The authors compared two groups of women in substance use treatment; those who were dependent on alcohol and those who were dependent on cocaine. Some of the factors they looked at included history of trauma, addiction severity, and symptoms of PTSD., An example of differences: women dependent on alcohol had more exposure to accidents and circumstances that resulted in serious injury, whereas, women who were cocaine dependent had greater social consequences.

Link to PubMed Abstract »

3. Ballon, B. C., Courbasson, C. M. A., & Smith, P. D. (2001). Physical and sexual abuse issues among youth with substance use problems. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 46(7), 617-621. Girls in adolescent substance use treatment in Canada had higher rates of both sexual abuse and physical abuse in comparison to boys in treatment. Of all those in treatment reporting abuse, girls were more likely than boys to use substances to cope with experiences of trauma.

Link to PubMed Abstract »

4. Bopp, J., van Brugen, R., Elliott, S., Fuller, L., Haché, M., Hrenchuk, C., et al. (2007). You Just Blink and it Can Happen: A Study of Women’s Homelessness North of 60, Pan-Territorial Report. Four Worlds Centre for Development Learning, Qulliit Nunavut Status of Women Council, YWCA Yellowknife, Yellowknife Women’s Society, Yukon Status of Women’s Council. Women in the North are particularly vulnerable to homelessness. Based upon over 250 interviews with homeless women in the Yukon, Nunavut and the Northwest Territories, this report explores the conditions that affect women in the North and includes an analysis of social determinants of health and experience of trauma and substance use, as well as policies affecting women.

Link to Document »

5. Boughton, R., & Falenchuk, O. (2007). Vulnerability and comorbidity factors of female problem gambling. Journal of Gambling Studies, 23(3), 323-334. This study surveyed 365 women gamblers from across Ontario about their personal history, mental health concerns and gambling behaviours.  Higher rates for abuse and co-occurring disorders were reported by women who gamble than by women in the general population. Prevention and treatment strategies for problem gamblers should take trauma, mental health and addiction histories into account

Link to PubMed Abstract »

6. Brady, K. T., Back, S. E., & Coffey, S. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions in Psychological Science, 13(5), 206-209. This study demonstrated that substance abuse and posttraumatic stress disorder commonly co-occur. Possible explanations are provided by the authors.

Link to Sage Abstract »

7. Christensen, R. C., Hodgkins, C. C., Garces, L. K., Estlund, K. L., Miller, M. D., & Touchton, R. (2005). Homeless, mentally ill and addicted: The need for abuse and trauma services. Journal of Health Care for the Poor & Underserved, 16(4), 615-621. This study looked at the lifetime prevalence of trauma, (specifically sexual or physical abuse) in a group of 78 homeless adults with co-occurring disorders. They found that 100% of the women and 68.6% of the men had experienced a life-altering traumatic event. The authors discuss the STAR program as a model for helping homeless people with co-occurring disorders.

Link to ProjMuse Abstract »

8. Dion, J., Collin-Vézina, D., De La Sablonnière, M. Philippe-Labbé, M.-P., & Giffard, T. (2009). An exploration of the connection between child sexual abuse and gambling in Aboriginal communities. International Journal of Mental Health Addiction. Child sexual abuse has long been linked as a potential risk factor to the development of addictions. In this article, the authors discuss the existing studies on the links between addictions and gambling. They note that gambling is more prevalent in Aboriginal populations and discuss possible reasons including historical trauma.

Link to Article »

9. Godard, L., Cory, J., & Abi-Jaoude, A. (2008). Building Bridges - Linking Woman Abuse, Substance Use and Mental Ill Health: Summary Report January 2008. Vancouver, BC: Woman Abuse Response Program, BC Women's Hospital. Based on the extensive interviews with service providers and policy makers in 82 British Columbia communities and the personal stories shared from women with lived experiences of violence and abuse, the Building Bridges initiative describes the interconnections of woman abuse, substance use and mental health issues for women. This report recommends integration of services for women and cross-sectoral collaboration as a way to improve service delivery and the health and safety outcomes for women.

Link to Report »

10. Hien, D., Litt, L. C., Cohen, L. R., Miele, G. M., & Campbell, A. (2009). Perspectives on traumatic stress, posttraumatic stress disorder, and complex posttraumatic stress disorder.  Trauma services for women in substance abuse treatment: An integrated approach. (pp. 9-17). Washington, DC: American Psychological Association. This  chapter offers a succinct overview of the relevance of trauma to understanding women with addictions concerns and explores the evidence for the self-medication model as explanatory.

Link to Book Overview »

11. Logan, T., Walker, R., Cole, J., & Leukefeld, C. (2002). Victimization and substance abuse among women: Contributing factors, interventions and implications. Review of General Psychology, 6(4), 325-397. This article provides a very comprehensive look at the high rates of the co-occurrence of substance use and victimization, which are described in the literature.  The authors discuss the complexity of this relationship and present a synthesis of the factors that have been identified as contributing to victimization and substance abuse.

Link to Presentation by Logan in PowerPoint.

12. Marquenie, L. A., Schadé, A., van Balkom, A. J. L. M., Comijs, H. C., de Graaf, R., Vollebergh, W., et al. (2006). Origin of the comorbidity of anxiety disorders and alcohol dependence: Findings of a general population study. European Addiction Research, 13(1), 39-49. This study found that anxiety and substance use disorders often co-occur and they have a distinct relationship and may be associated with childhood traumatic events. Further, the authors found that anxiety disorders precede alcohol dependency.

Link to Article »

13. Niccols, A., Dell, C. A., & Clarke, S. (2010). Treatment issues for Aboriginal mothers with substance use problems and their children. International Journal of Mental Health and Addiction, 8(2), 320-335. Link to

The authors discuss the issues concerning substance use by women who are pregnant or parenting. The article focuses on Canadian Aboriginal women in particular and reviews the unique challenges these women encounter, which include intergenerational trauma and colonization. 

Link to Article »

14. Poole, N., Greaves, L., Jategaonkar, N., McCullough, L., & Chabot, C. (2008). Substance Use by Women Using Domestic Violence Shelters. Substance Use & Misuse, 43(8/9), 1129-1150.
The authors describe the interconnections of substance use, violence and stress among women using domestic shelter services in British Columbia.

Link to PubMed Abstract »

15. Schneider, R., Burnette, M. L., Ilgen, M. A., & Timko, C. (2009). Prevalence and correlates of intimate partner violence victimization among men and women entering substance use disorder treatment. Violence And Victims, 24(6), 744-756.
Nearly 1 in 2 women and 1 in 10 men entering substance abuse treatment report lifetime abuse by an intimate partner. This abuse leads to a complex set of physical and mental issues that are often gender-specific.

Link to PubMed Abstract »

16. Stevens, S. J., Andrade, R. A. C., & Ruiz, B. S. (2009). Women and substance abuse: Gender, age, and cultural considerations. Journal of Ethnicity in Substance Abuse, 8(3), 341-358.
The rise of substance use among women is discussed within the context of violence and trauma, mental health concerns, physiological factors and cultural factors.

Link to Abstract »

17. Weaver, T.L., & Etzel, J.C. (2003). Smoking patterns, symptoms of PTSD and depression: Preliminary findings from a sample of severely battered women. Addictive Behaviors, 28, 1665-1679.
This study explores the relationship between smoking, depression and post-traumatic stress. The research findings reveal correlations between smoking levels and socio-economic factors, levels of physical abuse and controlling behavior, and basic life functioning. Implications for treatment and further research are explored.

Link to ScienceDirect Abstract »

18. Vaillancourt, A., & Keith, B. Substance use among women in “The Sticks”: Northern perspectives. In: Poole, N., Greaves, L., eds. Highs and lows: Canadian perspectives on women and substance use. Centre for Addiction and Mental Health, 2007:37-50.
The authors note that most of the understanding of women's substance use has come from research of urban women, and recommend specific attention should be focused on the needs and experiences of women in diverse geographic locations. In their study they conducted focus groups and individual interviews with:
1) women who used substances, and
2) service providers working with women who used substances. In their findings they discuss the intersecting nature of violence, stigma, economic challenges, and substance use as they affect women in rural communities.

Link to Highs & Lows »

19. Zilberman, M.L., Tavares, H., Blume, S. B., & el-Guebaly, N. (2003). Substance use disorders: Sex differences and psychiatric comorbidities. Canadian Journal of Psychiatry, 48(1), 5-13.
The authors performed a computerized search of health information databases in Canada to determine sex differences in psychiatric co-morbidities. They found that women with substance use disorders are more likely to have psychiatric co-morbidities than men. Additionally, the authors found that depression is often primary in women, while for men substance abuse is primary.

Link to PubMed Abstract »



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