This study examines the relationship between a history of physical and sexual abuse (PhySexAbuse) and drug and alcohol related consequences. We performed a cross-sectional analysis of data from 359 male and 111 female subjects recruited from an inpatient detoxification unit. The Inventory of Drug Use Consequences (InDUC), measured negative life consequences of substance use. Eighty-one percent of women and 69% of men report past PhySexAbuse, starting at a median age of 13 and 11, respectively. In bivariate and multivariable analyses, PhySexAbuse was significantly associated with more substance abuse consequences (p < 0.001). For men, age < or =17 years at first PhySexAbuse was significantly associated with more substance abuse consequences than an older age at first abuse, or no abuse (p = 0.048). For women, the association of PhySexAbuse with substance use consequences was similar across all ages (p = 0.59). Future research should develop interventions to lessen the substance abuse consequences of physical and sexual abuse.