The sample included 444 girls from a group of 1,824 adolescents who entered inpatient treatment for substance abuse between 1984 and 1986 and who consented to follow-up interviews after treatment. Substance use patterns, symptoms, and age of initiation were subjected to contingency analysis for subgroups of girls categorized by abuse victimization histories. Girls who reported intrafamilial abuse, extrafamilial abuse, or both were compared with nonvictims in terms of alcohol and drug use histories. Prevalence and frequency of alcohol, marijuana, and cocaine did not differ significantly among subgroups, although all sexual abuse victims were significantly more likely to regularly use stimulants, sedatives, tranquilizers, and hallucinogens. Sexual abuse victims also reported earlier onset of alcohol and drug use, more self-medication, and more drug use to escape family problems. The significant association between drug choice and sexual abuse victimization histories of adoelscent girls suggests the need for renewed focus on links among drug choice, personality factors, and life events. 55 references and 6 tables