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The purpose of this study was to explore the severity of substance abuse and reasons for using drugs among prostituting African American women who smoke crack cocaine. Specifically, we were interested in examining whether prostitutes use drugs as a means of coping with intra- and interpersonal experiences commonly associated with their occupation. Using a convenience sample of 203 African American women with a history of crack smoking, participants were interviewed and asked a variety of questions including whether they had ever engaged in prostitution as a source of income and the severity of and reasons for their drug use. Women who were prostituting, in contrast to those who were not, were found to have a significantly higher severity of drug use and were significantly more likely to use drugs to increase confidence, control, and closeness to others and to decrease feelings of guilt and sexual distress. We argue that women may enter prostitution in order to fund their drug use; however, prostitutes likely increase their drug use in order to deal with distress caused by activities associated with their occupation. The need to address the mental health issues of prostitutes who are abusing illicit drugs is discussed.
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