The impact of sexual victimization on substance use disorder treatment completion: A systematic review and meta-analysis

Abstract

Background:A significant proportion of individuals seeking treatment for substance use disorders (SUDs) have experienced sexual victimization, which has been shown to disrupt the efficacy of SUD treatment services. Objective: To evaluate the relationship between lifetime sexual victimization and SUD treatment completion. Methods: Relevant literature was identified through a systematic, computerized search of nine electronic databases (May 2018) and reference harvesting, yielding 15 peer-reviewed articles published between 1992 and 2017. Two authors independently conducted title and abstract screens, full-text reviews, data abstraction, and methodological appraisals. Risk of bias was assessed using a modified mixed-methods appraisal tool. Only nine studies met criteria for the meta-analysis, which used a random-effects model. Results: Included studies yielded mixed results regarding the impact of sexual victimization on treatment completion. The meta-analysis yielded a non-significant trend of survivors of sexual victimization having slightly lower odds of completing treatment. Conclusions: Findings from this systematic review and meta-analysis did not support the impact of sexual victimization on treatment completion. Methodological limitations of the extant literature limit cross-study comparisons. Future studies should document program-related factors to improve the ability to understand relationships affecting treatment completion.

Keywords:

• Systematic review
• meta-analysis
• substance-related disorders
• treatment
• sex offenses

Author contributions

A.P. and B.J. contributed to database searching, data extraction, methodological appraisal, data management, interpretation of results, and writing the manuscript. T.J. contributed to data analysis, interpretation of results, and writing and revising the manuscript. M.O.H. aided with the development of the search strategy, data collection methods, and methodological appraisal.

Acknowledgements

The authors gratefully acknowledge Angela Bardeen at the University of North Carolina at Chapel Hill for her guidance and feedback in the development of the search strategy.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.