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Sexual Abuse: A Journal of Research and Treatment, Vol. 12, No. 4, 2000

Alcohol and Drug Abuse in Sexual and Nonsexual

Violent Offenders
Jeffrey Abracen,1 Jan Looman,1 and Dana Anderson2

According to a literature review by Marshall (1996), presently available data have

not clarified the proportion of sexual offenders who would meet diagnostic criteria
for addictive problems. Our own literature review failed to find published studies comparing sexual offenders to nonsexual violent offenders on standardized
measures of substance abuse. Our study is a preliminary investigation of the differences between sexual offenders (rapists: n = 72; child molesters: n = 34) and
nonsexual violent offenders (n = 24) on measures of alcohol and drug abuse. The
findings indicate that sexual offenders were more likely to abuse alcohol than were
nonsexual violent offenders. Nonsexual offenders were significantly more likely to
have had a history of other forms of substance abuse. The results are considered
in terms of theories of alcohols contribution to aggressive behavior and sexual
aggression. Implications for assessment and treatment of sexual offenders are
discussed.
KEY WORDS: alcohol; drug abuse; sex offenders.

Approximately two-thirds of offenders in general experience substance abuse

problems to some degree (Boland, Henderson, & Baker, 1998). Research has
consistently concluded that alcohol problems, drug problems, and a mixture of
the two are associated with crime (Boland, Henderson, & Baker, 1998; Dowden &
Brown, 1998). With reference to sexual offenders specifically, a number of authors
point out the association between alcohol or substance abuse and sexual offending
(e.g., Christie, Marshall, & Lanthier, 1979; Rada, 1975). Marshall (1996) discussed
how a reexamination of some earlier data collected by his team revealed that 50% of
sexual offenders were intoxicated at the time of their most recent offence. Although
the level of intoxication was not always clear, there was evidence of problems
related to substance abuse in 60% of the sample. Other reports of alcohol abuse
1 Regional
2 Kingston

Treatment Centre (Ontario), 555 King St. West, Kingston, Ontario, Canada K7L 4V7.
Penitentiary, Kingston, Ontario, Canada.
263
C 2000 Plenum Publishing Corporation
1079-0632/00/1000-0263$18.00/0

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among sex offenders range from 0% to 52% (see Langevin & Lang, 1990, for
further discussion regarding this topic). Nonetheless, a meta-analysis (Hanson &
Bussi`ere, 1996) of the treatment literature relating to sexual offenders reported that
alcohol abuse was not significantly related to sexual recidivism, although alcohol
abuse was found to be significantly related to general recidivism.
In line with the findings of Hanson and Bussi`ere (1996), Elliott (1994) reported longitudinal data on a national probability sample of 1725 youths age 11
17 years in 1976. Nine waves of data were available on this group, who were
age 2733 years when they were interviewed in 1993. Both self-report and official
data were available for all respondents. With reference to serious violent offences
(SVOs), data were collected regarding aggravated assault, robbery, and rape. Data
were also collected on the use of drugs and alcohol immediately prior to the event.
Although it was difficult to determine the temporal relationship between minor
delinquency and alcohol use in the sample, SVOs were clearly preceded by both
alcohol use and delinquency. As well, minor delinquency was found to precede
all forms of illicit drug use. In contrast to what one might expect to see based on
Elliotts (1994) findings, Hawkins, Lishner, Jenson, and Catalano (1987) compared
a group of institutionalized delinquents with a group of high school seniors and
found higher prevalence rates for the use of all drugs other than alcohol among the
delinquent sample. The high school seniors evidenced higher rates of alcohol use
than the delinquent sample.
In his review of the literature, Marshall (1996) recommended that controlled
studies using standardized measures of substance abuse be used to investigate
the relationship between sexual offending and substance abuse. Unfortunately, to
date there have been very few such studies. One exception to this is Langevin
and Langs (1990) study, which found that less than one-fifth of their sample of
sex offenders had a drug abuse problem at the time of examination, as measured
by the Drug Abuse Screening Test (DAST). This was in marked contrast to the
finding that more than half of this sample were alcoholics based on the Michigan
Alcoholism Screening Test (MAST) data that they reported. One limitation of this
study, however, was that the authors did not include a comparison group.
There are a number of theoretical questions with clear clinical relevance regarding the association between substance abuse and sexual offending. One of the
most basic questions relates to whether rapists exhibit the same pattern of substance
abuse as child molesters and if these groups differ from other groups of violent
offenders. Drug abuse may be associated with greater alienation from mainstream
society relative to alcohol abuse given the fact that these substances are illegal. The
impact of this (if any) on the type of violent crime an individual engages in is an
empirical question that has received surprisingly little attention to date. Furthermore, research (e.g., McGue, Slutske, & Iacono, 1999) suggests that previous work
on alcoholism failed to control for comorbid drug use, and there may be important
differences between alcoholics with and without a history of drug abuse. The poor

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quality of many of the studies that have been produced with reference to offending
and substance abuse is clearly a contributing factor to this sate of affairs. Lightfoot
and Barbaree (1993) point out, for example, that most studies rely on unsubstantiated interview data. Very few studies appear to use standardized instruments.
In spite of the limited number of well-controlled studies regarding the association between substance abuse and sexual offending, a variety of theoretical models
have been presented to describe this association (see Barbaree & Marshall, 1991;
Lightfoot & Barbaree, 1993, for excellent reviews of this topic). With reference to
alcohol, theories have proposed that physiological factors, psychological factors,
or a combination of the two appear to be related to the frequently noted association
between alcohol and aggressive behavior. As noted by Langevin and Lang (1990),
drug use is considered important in sex crimes but less so than alcohol, which is
socially sanctioned. These authors also discuss the fact that it is more difficult to
study the use of other drugs given a number of uncertainties, not the least of which
is whether and to what extent the drug(s) the offender thinks he is consuming have
been mixed with other exogenous substances. At present, the available evidence
points to some combination of both physiological and psychological factors associated with substance abuse as being related to a variety of violent behaviors,
including sexual offending.
With reference to physiological factors, some research suggests that alcohol
increases ones preparedness to aggress (Boyatzis, 1974), and that intoxicated
subjects behave more aggressively than either subjects who received a placebo or
a no-beverage control group (Taylor & Leonard, 1983). In terms of psychological
factors, an individuals expectancies regarding alcohol may have some impact on
an individuals behavior (see Barbaree & Marshall, 1991, for a discussion). That is,
an individuals beliefs regarding the effect(s) of alcohol influence his subsequent
behavior and that physiological factors, even if present, are less relevant. Some
research (Marx, Gross, & Adams, 1999) shows that both alcohol per se as well
expectancies regarding the use of alcohol may have additive effects. These authors
found that both alcohol and the belief that one had consumed alcohol interfered with
the ability of male college students and sexually coercive men to determine when
males in an audiotaped description describing rape should refrain from making
further sexual advances.
There are two general purposes to the present study. The first is to determine whether sexual offenders exhibit the well-documented association between
alcohol and, to a lesser extent, other drugs and sexual offending when standardized measures of substance abuse are used. The second purpose of the study is
to examine the relative pattern of substance abuse among rapists, child molesters,
and violent nonsexual offenders. Data related to this second issue are important
in that they may shed some light on the whether the pattern of substance abuse is
differentially related to sexual offending versus other forms of violent behavior.
As only one well-controlled study could be located (Langevin & Lang, 1990) few

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specific hypotheses were identified for the present investigation. It was predicted
that sexual offenders would evidence high levels of alcohol abuse as measured
by the MAST. As this investigation was exploratory in nature, no other specific
predictions were made.
METHOD
Participants
There were 130 men who participated in the current study. All participants
were incarcerated in Canadian federal penitentiaries and were either assessed
or treated at Ontarios Regional Treatment Centre (RTC). Three groups of subjects were used. The first group consisted of 72 sexual offenders against adults
(Rapists). A second group consisting of 34 sexual offenders against children (Child
Molesters) were also included . No subject with a history of incest as the only sexual
offence on his police record was included in the present sample of sex offenders.
The classification of all sex offenders was based on the offenders official police
record. Individuals with victims over the age of 16 were classified as rapists. Child
Molesters were classified based on having had victim(s) under the age of 12. No offenders with a history of offending against both adults and children were included
in the present analyses. All subjects signed a consent form indicating that they
were voluntarily participating in the assessment or treatment program and that
assessment results would be used for research purposes. All subjects were also
informed that they were free to withdraw their consent to the assessment and/or
treatment at any time. The nature of the assessment and/or treatment program was
explained to the subject prior to his signing the consent form.
A comparison group (n = 24) consisted of individuals who were accepted
into a program for personality disordered offenders with violent offence histories
(PD group) were also included in the present study. The clients in this group were
also receiving treatment at the RTC. In order to avoid any overlap with the RTC
sex offender treatment program (SOTP), one of the criteria for inclusion in the PD
group was having had no history of sexual assault. Official police records were
used as the basis for classification. Nonetheless, if it were clear that the individual
had committed a sexual offence but received a conviction for a nonsexual offence
(e.g., in the case of a plea bargain), the client would have been referred to the RTC
SOTP. It is, of course, possible that one or more individuals in the PD group had
committed a sexual offence that was not detected by the treatment staff. However,
every attempt was made to minimize the chance of this occurring. All subjects in the
PD group signed a consent form indicating that they were voluntarily participating
in the treatment program and that assessment data would be used for research
purposes. All subjects were also informed that they were free to withdraw their
consent to treatment at any time. The nature of the treatment program was explained
to the subject prior to his signing the consent form.

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Procedure and Measures

As part of the assessment procedure for both the RTC SOTP as well as the
PD program, all men were administered the MAST (Selzer, 1971) and the DAST
(Skinner, 1982). The Violence Risk Appraisal Guide (VRAG; Webster, Harris,
Rice, Cormier, & Quinsey, 1994), a risk-assessment measure whose purpose is to
estimate the probability of violent reoffending, was also scored for subjects in all
groups.
The MAST consists of a series of 24 yes/no questions pertaining to lifetime
use of alcohol. Each item receives a score of 0 or 1, with scores of 9 and more
indicating evidence of having had a drinking problem at some point in ones
life. The MAST is a commonly used measure of alcoholism with demonstrated
reliability and validity.
The DAST is similar in design to the MAST. It consists of 20 yes or no
questions, each scored 0 or 1. Scores of 11 or more indicate substantial problems
with drug abuse. Langevin and Lang (1990) demonstrated using factor analysis in
a large sample (N = 461) of male sexual offenders that both the MAST and the
DAST could be treated as single-factor tests. Alpha reliabilities for the MAST and
the DAST were found to be .89 and .90, respectively.
The VRAG is a recently developed but now widely used instrument for predicting specifically violent recidivism. It is an empirically derived, 12-item actuarial scale based on an original sample of 685 offenders released from a maximumsecurity psychiatric facility. The Hare Psychopathy ChecklistRevised (PCL-R;
Hare, 1991) score is included in the scale. Original data indicated that scores
on the VRAG were positively related to recidivism, with a correlation between
violent reoffense and risk scores being .44. Rice and Harris (1997) reported a
cross-validation study involving 288 rapists and child molesters, 159 of whom
were not included in the original study. They found that scores on the VRAG
correlated .44 with violent (including sexual) recidivism.
The RTC SOTP is a high-intensity program offered to sexual offenders who
are deemed to be either a high risk to reoffend based on actuarial estimates of risk,
or as presenting with high treatment needs, or both. The PD program accepted individuals whose history indicated a persistent pattern of violent behavior. As noted,
to the best of the treatment staffs knowledge, no individuals in this program had a
history of sexual offences, as these clients would have been referred to the SOTP.
RESULTS
Descriptive Statistics
The mean age of the rapist group was 35.04 years, the mean age of the
child molester group was 38.45 years, and the mean age of the PD group was
33.59 years. These differences were nonsignificant. In addition, the groups did not

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Table I. Offense History (Convictions) for Offender Groups
Variable

Number of sexual offenses

Rapists (n = 72)
Child molesters (n = 34)
Violent offenders (n = 24)
Number of violent offenses
Rapists (n = 72)
Child molesters (n = 34)
Violent offenders (n = 24)
Number of nonviolent offenses
Rapists (n = 72)
Child molesters (n = 34)
Violent offenders (n = 24)

Mean

Standard deviation

2.35
5.29
0

4.18
7.81
0

2.31
1.38
2.75

2.12
1.89
2.88

14.01
10.24
34.79

12.41
11.18
22.97

p < .002.
p < .003.

differ significantly on the mean length of sentence, nor were their mean scores on
the actuarial assessment of risk (the Risk Appraisal Guide) significantly different.
Information on criminal history is presented in Table I. Because the PD group
contained no subject who had a sexual offense conviction on his record, the significant difference in sexual offense history was expected, F(2,130) = 8.06, p <
.002. However, the Scheffe test for multiple comparisons revealed that the Child
Molesters had significantly more sexual offense convictions than the Rapists did
(mean difference = 2.95, p < .05). The difference among mean number of nonviolent convictions was also significant, F(2,130) = 22.87, p < .001, such that the
PD group had a significantly higher mean number of nonviolent convictions than
both the Rapists (mean difference = 20.78, p < .001) and the Child Molesters
(mean difference = 24.56, p < .001) as indicated by the Scheffe test. Finally, the
difference among groups on the mean number of violent convictions approached
significance (F(2,130) = 3.08, p < .06).

Alcohol Abuse
Table II shows the numbers and percentages of each group of subjects who
fell into the categories of mild (score range: 03), moderate (score range: 49) and
severe (score: 10 and higher) levels of alcohol abuse.
As indicated in Table II, all groups endorsed, to some extent, items comprising scores for alcohol abuse. A chi-square analysis examining the frequencies of
offender group in each category of alcohol abuse revealed that the level of alcohol
abuse was related to the type of offender ( 2 (4, n = 130) = 15.58, p < .005).
Most of the severe alcohol abusers in this sample were sexual offenders (68.8%
of severe abusers were Rapists; 29.2% were Child Molesters), and most of the

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Table II. Level of Alcohol Abuse for Sexual and Nonsexual Violent Offenders
Level

Rapists
(n = 72)

Child molesters
(n = 34)

Violent offenders
(n = 24)

Mild (MAST score 03)

Moderate (MAST score 49)
Severe (MAST score 10 and above)

30.6% (22)
23.6% (17)
45.8% (33)

44.1% (15)
14.7% (5)
41.2% (14)

58.3% (14)
37.5% (9)
4.2% (1)

Note. The percentages indicate the proportion of subjects in each offense category who fell into
the level of alcohol abuse. The actual number of subjects is presented in parentheses.

Table III. Scores on MAST and DAST for Offender Groups

MAST

DAST

Group

Mean

Standard
deviation

Mean

Standard
deviation

Rapists (n = 72)
Child molesters (MAST: n = 34; DAST: n = 33)
Violent offenders (MAST: n = 24; DAST: n = 23)

9.29
7.09
3.67

7.18
6.62
3.62

5.54
4.27
8.04

5.40
5.32
3.59

Note. Asterisks indicate group means differ significantly: p < .03;

< .002.

sexual offenders were severe alcohol abusers (45.8% of Rapists; 41.2% of Child
Molesters).
Evident from examining the mean scores presented in the left half of Table III
is that the sexual offender groups all scored higher than the nonsexual PD group.
To determine whether the difference among means was statistically significant, a
one-way analysis of variance (ANOVA) was computed. The results indicated that
the groups differed significantly, F(2,130) = 6.88, p < .002. The Scheffe test for
multiple comparisons indicated that the Rapist group differed significantly from
the PD group (mean difference = 5.63, p < .003), and no other means differed
significantly. A covariate ANOVA controlling for history of drug abuse (as assessed
by DAST score) did not alter these findings of significance.
Drug Abuse
Two subjects had missing data for scores on the DAST and were hence excluded from the analyses. Table IV shows the numbers and percentages of each
group of subjects who fell into the categories of mild (score range: 05), moderate
(score range: 610) and severe (score: 11 and higher) levels of drug abuse.
All groups endorsed items that indicated drug abuse. A chi-square analysis
examining the frequencies of offender group in each category of drug abuse revealed that the level of drug abuse was related to the type of offender ( 2 (4, n =
128) = 32.85, p < .001). As evident from Table IV, most of the PD group fell into
the category of moderate drug abuse.

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Table IV. Level of Drug Abuse for Sexual and Nonsexual Violent Offenders
Level

Rapists
(n = 72)

Child molesters
(n = 33)

Mild (DAST score 05)

Moderate (DAST score 610)
Severe (DAST score 11 and above)

59.7% (43)
16.7% (12)
23.6% (17)

66.7% (22)
15.2% (5)
18.2% (6)

Violent offenders
(n = 23)
17.4% (4)
73.9% (17)
8.7% (2)

Note. The percentages indicate the proportion of subjects in each offense category who fell
into the level of alcohol abuse. The actual number of subjects is presented in parentheses.

Evident from examining the mean scores presented in the right half of Table III
is that the PD group had a higher mean score on the DAST than either of the
sexual offender groups. A one-way ANOVA indicated that the groups differed significantly, F(2,128) = 3.74, p < .03. The Scheffe test for multiple comparisons
indicated that the PD group differed significantly from the Child Molester group
(mean difference = 3.77, p < .03), and no other means differed significantly. A
covariate ANOVA controlling for history of alcohol abuse (as assessed by MAST
score) did not alter these findings of significance.
DISCUSSION
The results of the present investigation indicate that sexual offenders report
high levels of alcohol abuse more frequently than do nonsexual violent offenders.
The results are reversed when examining lifetime history of drug abuse where
the PD group demonstrated significantly higher mean scores relative to the sexual
offenders. The difference between these groups in this investigation appears more
pronounced with respect to the alcohol abuse. Fewer than half of the nonsexual
violent offenders reported more than mild alcohol abuse levels, whereas approximately 40% of both groups of sexual offenders reported severe levels of alcohol
abuse.
These findings indicate empirical support for clinical observations that alcohol
abuse history is prevalent among sexual offenders. This study makes a unique
contribution to the existing literature in that it compares substance abuse levels
of sexual offenders to those of nonsexual violent offenders. Langevin and Lang
(1990) asserted the importance of incorporating substance abuse in the assessment
and treatment of sexual offenders, noting that the literature repeatedly reports
more alcoholics among sexual offenders than among the population at large. Our
findings strengthen the assertion of Langevin and Lang (1990) by indicating that
alcohol abuse is more prevalent among sexual offenders than even among violent,
nonsexual offenders.
The current data also indicate that child molesters and rapists evidence similar levels of substance abuse. No significant differences were observed between
groups of sexual offenders on either the MAST or the DAST. When problems

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with alcohol were examined controlling for history of drug abuse, the data were
relatively unchanged. The same findings applied to drug abuse when level of
alcohol abuse was controlled. The findings of McGue et al. (1999) are interesting in this regard. These authors found that alcoholism appears to be associated primarily with negative emotionality and not disinhibition, but only when
drug use disorders are statistically controlled. If alcoholism is in fact associated
with negative emotionality, this may lend some credence to the theory proposed
by Marshall and colleagues (e.g., Seidman, Marshall, Hudson, & Robertson,
1994) regarding intimacy deficits in sex-offenders. These authors have found
that sex offenders were more lonely and deficient in intimacy than other offenders and community controls. It may be, for example, that alcohol abuse
but not drug abuse interacts with sexual offenders preexisting negative emotional state (e.g., loneliness) in meaningful ways. At present, all that is certain
is that more research should be conducted to investigate this proposed association as well as the manner in which substance abuse either contributes to the
development of such intimacy deficits or exacerbates already existing deficits.
Another area of possible research is the link between deviant sexual fantasies,
negative emotionality, and substance abuse. Previous research (e.g., Cortoni, Heil,
& Marshall, 1996; Looman, 1999) suggests that sexual offenders are more likely to
use sex and/or fantasies to cope with negative emotional states than are nonsexual
offenders.
In contrast to the position adopted by McGue et al. (1999), Seto and Barbaree
(1995) have proposed a disinhibition model linking alcohol to sexual aggression.
In their review, they outline empirical support for some of the stages they propose and suggest future directions for research. The fact that differences between
sex offenders and the PD group were found indicates that the literature linking
aggressive behavior to substance abuse is not sufficient to extrapolate to sexually
aggressive behavior in particular. In other words, despite the abundance of research
on alcohols and drugs effects on aggression, we may need to look for different
mechanisms operating for sexual aggression. Because those persistently violent
offenders (as the PD group were classified for the purposes of the treatment program in which they were enrolled) reported less severe alcohol abuse than did
the sexual offenders, there may be a better explanation for the links between alcohol abuse and sexual aggression than the current models connecting alcohol to
aggressive behavior in general.
Seto and Barbaree (1995) point out some difficulties with conducting this type
of research, and one of the limitations of this study is highlighted as an obstacle in
their review. They note that alcohol use is commonly assessed through self-report
measures, and they suggest that sexual offenders may be more likely to report
higher levels of alcohol abuse than nonsexual offenders because the former group
may wish to emphasize situational factors to minimize their responsibility for the
offense. In other words, sexual offenders might be more likely to highlight the importance of alcohol to lend credence to their explanation of the sexually aggressive

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behavior as beyond their control. Certainly, clinical experience would support this
assumption. However, if this were the case, the results of both self-report measures
of substance abuse in the present study should look similar, given that both drug
and alcohol abuse were assessed by self-report, and both would classify as situational factors that could absolve personal responsibility for the offense. Therefore,
we would expect that the sexual offenders would consistently report higher levels
of both drug and alcohol abuse, and this would result in higher mean scores for
the sexual offenders on both variables. This is not the case: The majority of the
sexual offenders reported only mild levels of drug abuse, whereas the majority of
nonsexual offenders reported moderate levels.
One difficulty of using the DAST to assess drug abuse is that this measure
does not differentiate among different types of drugs with different effects. In order
to more clearly delineate the relationship of drug abuse to sexual offending, we
would need to investigate particular types of drugs. It is possible, for example,
that sexual offenders are more likely to abuse certain classes of drugs, whereas
nonsexual offenders may abuse other types of drugs.
Another limitation of the present study is that we did not examine any other
correlates that might suggest the mechanisms by which alcohol or drug abuse
influences sexually aggressive behavior. The relationship between these variables
is not expected to be simple, as it is not simple in the relationship between alcohol
and general aggression. Research on attitudes toward women, acceptance of rape
myths, and endorsement of violence in general suggests that some of these variables
(as well as others) could predispose an individual to behave in markedly different
ways from another, given the same level of intoxication. Similarly, other social
psychological theories might indicate some of the mechanisms by which alcohol
or drug abuse exerts its effects on sexual aggression, and these mediating effects
may be akin to those described in research on aggressive behavior, risk-taking
behavior, and/or sexual behavior.
However, even though we do not have a definitive model of the relationship
between substance abuse and sexual aggression, this study indicates that substance
abuse is a particular concern for treatment providers who work with sexual offenders. These data support the assertion that treatment professionals who work with
violent offenders should have training in the area of substance abuse. Approaches
to the treatment of sexual offenders must focus on coping strategies, particularly
for areas of difficulty embedded in the offense chain or cycle. Concomitant substance abuse programs, for those offenders who require them, should be available
in any facility or institution offering treatment services to sexual offenders. Although monetary considerations must be taken into account in the design of any
program, it must be stressed that the cost of sexual offenses to society is enormous
(Marshall, Laws, & Barbaree, 1990). Continuing to research issues in the etiology
and treatment of sexual offenders is the only way of ultimately reducing these
costs, as well as the immense suffering, to society.

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ACKNOWLEDGMENTS
The authors wish to thank Dr. R. Karl Hanson and two anonymous reviewers
for their comments on an earlier draft of this paper.

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