Adverse childhood experiences can cause lasting impacts on adults. The trauma caused by these experiences heavily influences substance use. To better understand this phenomenon, it is important to understand how ACEs impact the body and brain.
The CDC-Kaiser ACE Study
In 1998, the study conducted by the Centers for Disease Control (CDC) and Kaiser Permanente on adverse childhood experiences (ACE) turned the medical world upside down.
To date, the CDC-Kaiser study is one of the largest examinations of the way childhood abuse, neglect, and household environments impact adult physical and mental health. Seventeen thousand participants answered surveys on their childhood and current life and health. The study focused on ten adverse childhood experiences:
- Physical abuse
- Verbal abuse
- Sexual abuse
- Physical neglect
- Emotional neglect
- A parent who’s an alcoholic
- A mother who experienced domestic violence
- A family member in jail
- A family member with a mental illness
- Parents who divorced
The results were astounding. The more ACEs a child experienced, the more likely they were to experience chronic illness, engage in risky behaviors, and engage in substance use. Since then, researchers have sought to replicate and expand the understanding of this study.
ACEs and Toxic Stress
While it has been known that ACEs correlate to higher instances of chronic illness for a long time, it was not always understood why. Now it is understood that ACEs cause toxic stress. Toxic stress is the effect of constant and excessive activation of stress on a child’s brain, immune system, cardiovascular system, and inflammatory system.
As stated by the Center on the Developing Child at Harvard University in their webpage titled ACEs and Toxic Stress: Frequently Asked Questions, “When a child experiences multiple ACEs over time—especially without supportive relationships with adults to provide buffering protection—the experiences will trigger an excessive and long-lasting stress response, which can have a wear-and-tear effect on the body….”
Sadly, this situation is often seen in celebrity mental health and the abuse and trauma they faced as young actors on screen.
This wear-and-tear is noticeable in the statistics. Of the 2017 ten leading causes of death in the United States, four or more ACEs double to triple the likelihood of seven leading causes of death. It also made Alzheimer’s and dementia 11.2 times more likely.
Scariest of all, it increased the likelihood of attempting suicide 37.5 times. The only leading cause of death not known to be impacted by ACEs is influenza.
ACEs and Substance Abuse
The scientific world knows, based on many repeated studies, that ACEs influence the likelihood of developing substance use disorders (SUDs). Toxic stress plays a factor in this outcome. To better understand how prevalent the issue is, it is necessary to look at additional data.
Three major studies offer insight into the way ACEs relate to substance abuse.
- A 2003 study published in Pediatrics retrospectively studied ACEs in relation to illicit substance use. They aimed to better understand childhood stress and trauma on the initiation of illicit substances. Their results found a strong connection between ACEs and illicit substances. People who reported five or more ACEs were seven to ten times more likely to report illicit drug use and addiction. Additionally, the exact number of ACEs played a role in the age of initiation. For every ACE an individual experienced, they were two to four times more likely to start using before they were 14 years old.
- A 2000 study published in Child Abuse and Neglect examined the connection between an individual ACE—sexual abuse—and substance abuse. People who reported childhood sexual abuse (CSA) reported alcohol or drug dependence three times more frequently than those who did not report CSA. Multiple instances of CSA provided the strongest predicting factor, even when controlled for parental substance abuse.
- A 2010 study published in Addiction Behaviors took on a lofty goal. They wanted to understand if ACEs directly correlated with substance abuse. The researchers believed mood and anxiety disorders would prove the mitigating factor between ACEs and SUD. They specifically used parental substance use and violent crime/abuse (separated into units of violent crime, physical abuse, and sexual abuse) as the ACEs. Based on the study design, individuals could experience 0-3 units of violent crime/abuse.
The results proved them both correct and incorrect. Participants diagnosed with a mood or anxiety disorder showed higher rates of SUD in conjunction with the ACEs. People in this category who experienced parental substance use were about two times more likely to report SUD. People who experienced violent crime/abuse reported SUD 1.76 times more frequently per unit. This does not mean mood or anxiety disorders explain the whole connection.
SUD rates still increased with ACEs in participants who had no diagnosed mood or anxiety disorder. In this category, people with parental substance use reported SUD one and a half times more often. People who went through violent crime/abuse reported SUD 1.42 times more frequently per unit. This clearly shows a connection between ACEs and SUD even without mitigating factors.
What to Do with This Information
Based on our knowledge of ACEs and SUD, we can draw a few inferences.
- Firstly, children of people with SUD need extra social and mental health support. They already have at least one known ACE. Due to the nature of addiction, they may experience more.
- Secondly, general physicians need to screen patients for ACEs. If a person receives a high ACE score, they need to be warned about their heightened risk of SUD.
- Lastly, dual diagnosis treatment programs will likely prove more effective for people attending detox and rehab. People with SUD often experienced childhood trauma. Treating these as co-occurring conditions will likely lead to better long-term sobriety.
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The ACEs study helped revolutionize the world’s understanding of childhood trauma and its lasting effects. We now know that experiences from a young age can create long-lasting impacts on physical health, mental health, and adult behavior.
If you are looking to enter treatment for SUD, you should take an ACE evaluation. If you come back with multiple ACEs, you should consider your treatment options. Do you want a co-occurring disorder program? Do you want to treat the trauma separately? You should make these decisions before starting down a treatment path.
When you’re ready to begin healing, DetoxNearMe.com is the best way to find a quality detox center near you. With thousands of listings at your fingertips, finding a drug detox for your needs, history and budget has never been easier.
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