Exploring Childhood Trauma’s Impact on Substance Use

Introduction

Some people are more likely to develop substance use disorders than others. Researchers at the Medical University of South Carolina (MUSC) conducted a study to investigate whether adverse childhood experiences (ACEs) contribute to this susceptibility.

Study Details

The study involved men and women participating in substance use research. They were asked to complete an ACE questionnaire and provide information about their use of tobacco, alcohol, cocaine, and opioids.

“Substance use disorders don’t occur in a vacuum. The use of more highly stigmatized drugs may be associated with worse childhoods.”
— Dr. Erin Martin

The study was led by Aimee McRae-Clark, Pharm.D, professor of Psychiatry and Neuroscience, and neuroscience doctoral candidate Erin Martin. The research was funded by the National Institute on Drug Abuse.

Findings

The study found that participants with a history of diverse ACEs were more likely to develop substance use disorders and experience relapse after treatment. Women, who reported more frequent and varied ACEs, were particularly prone to using drugs such as cocaine or opioids.

ACEs are traumatic events that occur during childhood, including abuse, neglect, witnessing violence, and experiencing household dysfunction. According to the Centers for Disease Control and Prevention (CDC), individuals with ACEs are at a higher risk of experiencing poorer mental and physical health, as well as worse educational and socio-economic outcomes. The number of ACEs a person experiences correlates with their risk of developing substance use disorders.

Impact on Substance Use

The study found that individuals who experienced a greater variety of ACEs were more likely to use drugs like cocaine or opioids. Those with opioid use disorder were more likely to have experienced household dysfunction, such as the incarceration or death by suicide of a parent. On the other hand, individuals with cocaine use disorder were more likely to have experienced emotional or physical abuse.

However, users of tobacco and cannabis were less likely to have experienced as many ACEs compared to those using cocaine and opioids. This difference may be attributed to the perceived risk associated with these substances. People with more ACEs tend to engage in risk-taking behavior, and cannabis and tobacco may not be perceived as risky.

Gender Differences

The study also revealed gender differences, with women reporting ACEs more frequently than men. Women reported ACEs related to sexual abuse up to four times more often than men. This higher burden of ACEs could explain why women are more vulnerable to rapidly progressing from drug use to drug addiction, a phenomenon known as telescoping.

Implications for Treatment

The current treatments for substance use disorders are often tailored to the specific substance rather than the individual. The researchers emphasize the need for comprehensive and personalized approaches to treatment and prevention, taking into account the role of ACEs in the development of substance use disorders.

“Adverse childhood events can inform future treatment directions. Trauma-focused interventions are important.”
— Dr. Aimee McRae-Clark

By understanding substance use disorders in greater detail, including the impact of ACEs, healthcare professionals can provide more effective and empathic interventions.

Conclusion

The study conducted by MUSC highlights the significant influence of childhood trauma on the development of substance use disorders. The findings underscore the importance of addressing ACEs and implementing trauma-focused interventions to improve treatment outcomes and prevent substance abuse.

Reference

Martin EL, Neelon B, Brady KT, Guille C, Baker NL, Ramakrishnan V, Gray KM, Saladin ME, McRae-Clark AL. Differential prevalence of Adverse Childhood Experiences (ACEs) by gender and substance used in individuals with cannabis, cocaine, opioid, and tobacco use disorders. Am J Drug Alcohol Abuse. 2023 Mar 4;49(2):190-198. doi: 10.1080/00952990.2023.2171301. Epub 2023 Mar 7.