Adverse Childhood Experiences and Addiction

Abstract

Two decades of research on adverse childhood experiences (ACEs) and a half century of research on child abuse and neglect provide evidence that early life mistreat-ment and family dysfunction increase the risk of subsequent use and abuse of mood-altering substances. In the original ACEs study of more than 17,000 patients, most of whom were middle-class, middle-aged, and non-Hispanic Caucasian, having four or more of the 10 identified ACEs (mental, physical, sexual abuse; mental, physical neglect; parental substance use, criminality, mental illness, divorce; domestic violence) increased the risk of self-reported alcoholism seven-fold, of illicit drug use 4.5-fold, and of injected drug use 11-fold (Anda et al. 2006; Dube et al. 2001, 2003). Similar findings have been documented in other large population samples in the United States and Europe, with drug and alcohol abuse increasing with number of ACEs in a dose-response effect (Campbell et al. 2016; Merrick et al. 2018). The relationship between ACEs and substance abuse is even more pronounced in adolescents and young adults living in lower-income and higher-crime neighborhoods than the original ACEs study population (Allem et al. 2015; Mersky et al.