Adverse childhood experiences and early initiation of substance use: A survival analysis

Objective Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using...

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Bibliographic Details
Published in:	International journal of psychiatry in medicine Vol. 59; no. 2; pp. 218 - 231
Main Authors:	Meadows, Amy L, Strickland, Justin C, Hyder, S Maela, Basconi, Rita C, Stull, Margaret E, Wagner, Frances P, Nguyen, Mai N, Rayapati, Abner O, Rush, Craig R
Format:	Journal Article
Language:	English
Published:	Los Angeles, CA SAGE Publications 01-03-2024 Sage Publications Ltd
Subjects:	Adverse Childhood Experiences Analgesics, Opioid Child Child Abuse Drug use Humans Narcotics Prescription drugs Substance-Related Disorders - epidemiology Survival Analysis substance use opioid use disorder initiation of substance use mental illness psychology substance use disorder psychiatry adverse childhood experiences
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Summary:	Objective Early adversity, such as adverse childhood experiences (ACEs), is a risk factor for the development of substance use disorder (SUD). ACEs are associated with earlier initiation of substance use. This study examined the relationship between ACEs and age of initiation of substance use using survival analysis. It is hypothesized that individuals with higher ACEs will have an earlier age of initiation. Method Participants were recruited from the University of Kentucky's Laboratory for Human Behavioral Pharmacology. Participants were 18 years or older, English speaking, and actively engaged in substance use. Participants were not in substance abuse treatment nor were they seeking treatment. ACE scores were calculated, and age of substance use initiation was recorded. A Cox proportional hazard model was used to examine the effect of ACE score on age of substance use initiation. Results A total of 107 participants completed the study. An average number of 2.3 ACEs (SD = 2.2) were endorsed with 24% of participants reporting 4 or more ACEs. Higher ACE scores were associated with cigarette smoking and non-medical prescription opioid use onset ( hazard ratio (HR) = 1.14, 95% CI=1.02–1.28, p = 0.02, and HR=1.19, 95% CI = 1.04–1.37, p = 0.01, respectively. Conclusions A significant association was found between higher ACE scores and earlier initiation of cigarette and non-medical prescription opioid use, consistent with prior research. Primary prevention of ACEs, screening for ACEs during childhood, and interventions for ACEs if detected, may help to reduce the risk of substance use/SUD in adulthood.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0091-2174 1541-3527 1541-3527
DOI:	10.1177/00912174231195751