Seventy-seven volunteer participants enrolled in eight substance abuse treatment facilities were surveyed using the Substance Abuse and Incest Survey. Of the sample, 36 (48%) reported histories of incest. For participants reporting incest, data on substance abuse history, perceptions of the relationship between incest and substance abuse, and opinions regarding incest-related counseling in the context of substance abuse treatment are presented. Recommendations for substance abuse professionals and facilities are made, including intake screening, barriers to treatment, counselor education, and future research.