This study examines how activities associated with prostitution may affect the severity and nature of women’s drug use. An argument is made that even though prostitutes may have started prostituting in order to support their drug use, the psychological distress caused by activities associated with their occupation leads them to increase their drug use as a means of coping. Using a 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. The study suggests the necessity to address the mental health issues of prostitutes in order to fully understand the interplay between prostitution and drug use. The prevalence of prostitution could be reduced by not only attending to the mental health needs of prostitutes that appear to perpetuate the prostitution-drug use cycle, but in addition, by addressing the larger social and economic forces that also contribute to their need to engage in prostitution. References