There is considerable literature on the consequences of childhood adversity and childhood sexual abuse (CSA) in women presenting for alcohol and drug treatment. Exploring the connections between child abuse and the development of alcohol and drug problems is made difficult by the diversity of definition and methods used across studies, possible under-reporting, and the attribution of effects of multiple forms of child abuse. Nevertheless, studies continue to show a consistent relationship between different forms of childhood adversity and subsequent alcohol and drug problems. This study interviewed 80 women consecutively admitted to the Community Alcohol and Drug Service (CADS) with the goal of establishing the extent of childhood adversity including childhood sexual, physical, and emotional abuse and parental problems. The 80 women in the sample ranged in age from 18 to 73 years. Although the majority of women were of European origin (76 percent), Maori women made up 20 percent of the sample. The large majority of women were heterosexual (89 percent), with lesbians making up 5 percent, and bisexual women comprising 6 percent. The results showed that a significant portion of the women came from backgrounds characterized by parental conflict and alcohol and drug problems. Within their first 15 years, 51 percent were subjected to sexual abuse involving attempted or completed oral, anal or vaginal intercourse, and 39 percent were exposed regularly to physical abuse perpetrated by their parents or main parental figures. Over half reported experiencing emotional abuse rated as “very distressing” and two-thirds had been exposed to “very distressing” parental problems. The main implication for clinical practice due to this study is the need for the development of a broader approach to alcohol and drug service provision. In order to achieve positive treatment outcomes, alcohol and drug service may need to routinely screen and plan treatment for childhood adversity and associated problems in all clients presenting for alcohol and drug treatment. Tables, references