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Substance use disorders (SUDs) are a pervasive public health problem with deleterious consequences for individuals, families, and society. Furthermore, SUD intervention is complicated by the continuous possibility of relapse.

The effect of prenatal cocaine exposure (PCE) on externalizing behavior and substance use related problems at 15 years of age was examined. Participants consisted of 358 adolescents (183 PCE, 175 non-cocaine exposed (NCE)), primarily African–American and of low socioeconomic status, prospectively enrolled in a longitudinal study from birth.

Structural equation modeling was used to examine the relationship of childhood trauma, educational level, and the use of avoidant coping on substance abuse and psychological distress in a community sample of 285 women. Results indicated that self‐reported childhood trauma was significantly related to greater substance abuse and psychological distress, through educational attainment and avoidant coping strategies.