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ADDICTION & SELLING SEX

Unless specifically noted otherwise, the studies cited on this page refer to women who sell sex in general and do not differentiate between the sex trade areas — for example on the street versus online  — nor do they differentiate between trafficked versus non-trafficked people

ACCORDING TO THE EXPERTS

“Prostitution and addictions reinforced each other, and created a life course trajectory in which incarceration was inevitable.”

Belcher, J., and Herr, S., “Development of Grounded Theory: Moving Towards a Theory of the Pathways into Street Prostitution Among Low-Income Women.” 2005. Journal of Addictions Nursing. 16:117–124

“Drug abuse is as likely to follow the sale of sex as to precede it”

McClanahan, S., et al “Pathways Into Prostitution Among Female Jail Detainees and Their Implications for Mental Health Services.” Psychiatric Services. 1999. 50;(12)

THE BIG TAKEAWAY

Although drug use is higher in among women who sell sex than those who do not, drug use alone does not predict entry into prostitution. 1,2​

  1. McClanahan, S., et al “Pathways Into Prostitution Among Female Jail Detainees and Their Implications for Mental Health Services.” Psychiatric Services. 1999. 50;(12)

  2. Medrano, M., et al. “Childhood Trauma and Adult Prostitution Behavior in a Multiethnic Heterosexual Drug-Using Population.” 2003. The American Journal of Drug and Alcohol Abuse, 29:2, 463 – 486

ADDICTION & THE SEX TRADE

  • 44-51% of women in a substance-use treatment program have sold sex 1,2,3

  • 19% of all addicted men have done sex work 1

  • 75-99% of women who sell sex struggle with substance abuse 6,7,8

  • 49-83% have been in drug treatment at least once 4,6

  • 83% started drug use as teen 4,5

  • 51% specifically started drug use as a way to escape abuse at home 4

  • 18%-37% specifically started selling sex as a way to pay for drug use 7,8

  • 19-24% started using drugs and selling sex at the same time 8

  • 46% of women who sell sex and inject drug started injecting after entry into selling sex 11

  • 22-63% were not addicted when they started selling sex 8,10

  1. Burnette, M.L., et al. “Prevalence and Health Correlates of Prostitution Among Patients Entering Treatment for Substance Use Disorders.” 2008. Archives of  General Psychiatry. 2008;65(3):337-344 [51% of women 19% of men in substance-use program report past year sale of sex regardless of the substance addicted to (alcohol, prescription pills, heroin, cocaine, meth, etc.)]

  2. Burnette, M.L., et al. “Women’s Past-Year Prostitution Status and Receipt of Substance Abuse Treatment Services.” Psychiatric Services. 2008 59;12 [41% of women in substance-use program report past year sale of sex]

  3. Rash, C.J., et al. “A retrospective and prospective analysis of trading sex for drugs or money in women substance abuse treatment patients.” Drug Alcohol Dependence. 2016. 162: 182–189 [44% of women in substance-use program have history of selling sex]

  4. Romero-Daza, N., Weeks, M., & Singer, M. ‘‘Nobody Gives a Damn if I Live or Die’’: Violence, Drugs, and Street-Level Prostitution in Inner-City Hartford, Connecticut.” Medical Anthropology. 2003. 22:233–259 [29 of 35 addicted women selling sex started drug use as teen (83%); 18 of 35 started using drugs to escape home life (51%); 17 of 35 had been in drug treatment (48%)]

  5. Surratt, H., et al. “Sex Work and Drug Use in a Subculture of Violence.” Crime & Delinquency. 2004. 50;(1)43-59 [Of 325 women who sold sex and were involved in drugs, average first marijuana use was at 15 years old and first alcohol use at 15.5]

  6. Fehrenbacher, A., et al. “Exposure to Police and Client Violence Among Incarcerated Female Sex Workers in Baltimore City, Maryland.” American Journal of Public Health. 2020. 110(51) [of 250 incarcerated women who sold sex, 99% report drug use in past 3 months; 78% started selling sex to get drugs; 83% had drug treatment history]

  7. Benoit, C., & Millar, A. “Dispelling Myths and Understanding Realities: Working Conditions, Health Status, and Exiting Experiences of Sex Workers.” 2001. The Michael Smith Foundation for Health Research. [Of 201 current and former women who sold sex in Victoria, British Columbia, Canada: 17.5% started selling sex as a way to pay for drug use;  40.9% used crack or cocaine; 31.3% used heroin and 7.1% use meth]

  8. Dalla, R. “Night moves: a qualitative investigation of street-level sex work.” 2002. Psychology of Women Quarterly. 26 (2002), 63–73 [Of 43 women who sold sex on the street, 95% reported drug use; 37% of those women were drawn to prostitution to support a  drug habit, and 19% reported entry into selling sex and drug abuse occurred simultaneously (therefore 63% of the women were not addicted when they started selling sex)]

  9. Farley, M. and Barkan, H. “Prostitution, violence, and posttraumatic stress disorder.” Women & Health. 1998; 27(3) [75% reported substance use disorder]

  10. McClanahan, S., et al “Pathways Into Prostitution Among Female Jail Detainees and Their Implications for Mental Health Services.” Psychiatric Services. 1999. 50;(12) [Of 1,142 female jail detainees, 34.1% reported ever selling sex and of those who reported selling sex one or more times per week with moderate/severe substance use: 67% were addicted before selling sex; 22% were not addicted before selling sex; 10% were uncertain which came first]

  11. Morris, D. M., et al. “Factors associated with pathways toward concurrent sex work and injection drug use among female sex workers who inject drugs in Northern Mexico,” Addiction. 2013. 108(1):161–170 [Of 575 females selling sex who injected drugs in the border cities of Tijuana and Ciudad Juarez, Mexico, 46% did not inject drugs before selling sex; 29% did inject drugs before selling sex, and 24% initiated both at the same age]

AGE AND FIRST USE

Of 325 women who sold sex on the street and used drugs in Miami, Florida in 2004: 1

15 — average age first used alcohol and marijuana

20 — average age first used cocaine

23 — average age first used heroin

26 — average age first used crack 

  1. Surratt, H., et al. “Sex Work and Drug Use in a Subculture of Violence.” Crime & Delinquency. 2004. 50;(1)43-59

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