This study considered the role of schema-level cognitive processes in alcohol and opiate abuse. It examined the hypothesis that alcohol abuse will be associated with the use of “blocking” behaviours to reduce the experience of emotions (secondary avoidance of affect), while opiate abuse will be associated with a tendency to avoid emotions being activated in the first place (primary avoidance of affect). The sample consisted of 30 patients who abused alcohol, and 30 who abused opiates. Each completed the Young Compensatory Inventory (YCI) and the Young-Rygh Avoidance Inventory (YRAI). There were no differences between the groups in their absolute levels of schema processes (YCI and YRAI scores). However, they differed in the way in which the severity of use was associated with the level of YRAI behavioural-somatic avoidance. Among alcohol abusers only, severity of use was greater in those who were more likely to avoid affective arousal in this way. This association with severity was not found among opiate abusers. Implications are discussed for existing treatments and for the use of schema-level cognitive behavioural interventions with substance-using populations.

Objectives: This study examines the frequency of childhood sexual abuse and physical abuse in a cohort of opiate addicted patients and looks at clinical correlates in those abused.

Method: Fifty-two consecutive patients attending an out patient drug treatment programme were interviewed using a semi-structured technique. Demographic details, details of schooling, marital status and number of children were recorded. The duration of drug abuse, age of onset of opiate abuse, early life experiences of both child sex abuse and childhood violence and a family history of alcohol abuse were also investigated.

Results: 21.2% of patients gave a history of sex abuse, with 23.1% of patients having a history of exposure to violence as a child. Those exposed to sex abuse had an earlier age of onset of opiate injection. A correlation between parental alcohol abuse and sex abuse and violence was noted.

Conclusions: A history of child sex abuse was associated with earlier onset of opiate abuse in this group of patients. The relatively frequent incidence of abuse and violence in those with opiate abuse must be born in mind when providing treatment. The addressing of issues relating only to addiction leaves earlier traumas continuing to exert an influence on the patient.