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

Amy L. Meadows; Justin C. Strickland; S. Maela Hyder; Rita C. Basconi; Margaret E. Stull; Frances P. Wagner; Mai N. Nguyen; Abner O. Rayapati; Craig R. Rush

doi:10.1177/00912174231195751

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

Amy L. Meadows
, Justin C. Strickland
, S. Maela Hyder
, Rita C. Basconi
, Margaret E. Stull
, Frances P. Wagner
, Mai N. Nguyen
, Abner O. Rayapati
, Craig R. Rush

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

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.

Original language	English
Pages (from-to)	218-231
Number of pages	14
Journal	International Journal of Psychiatry in Medicine
Volume	59
Issue number	2
DOIs	https://doi.org/10.1177/00912174231195751
State	Published - Mar 2024

Bibliographical note

Publisher Copyright:
© The Author(s) 2023.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute on Drug Abuse (NIDA) [R01DA047391], [R01DA043938], [R01DA048617], [R01DA036550], [R01DA045023], [R01DA047368], [T32 DA07209], [R13DA042568], [K23DA054309]; and the National Institute on Alcohol and Alcoholism (NIAAA) [R01AA026255], [R21AA026129]. The funding body had no role in the design, analysis, or interpretation of the study. The authors wish to thank all participants in the study and the University of Kentucky’s Laboratory for Human Behavioral Pharmacology. This research was previously presented at the American Psychiatry Association 2019 Colloquium for Junior Psychiatrist Investigators and at the Association for Medicine and Psychiatry 2019 Annual Meeting as a poster. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the National Institute on Drug Abuse (NIDA) [R01DA047391], [R01DA043938], [R01DA048617], [R01DA036550], [R01DA045023], [R01DA047368], [T32 DA07209], [R13DA042568], [K23DA054309]; and the National Institute on Alcohol and Alcoholism (NIAAA) [R01AA026255], [R21AA026129]. The funding body had no role in the design, analysis, or interpretation of the study.

Funders	Funder number
University of Kentucky’s Laboratory for Human Behavioral Pharmacology
Author National Institute on Drug Abuse DA031791 Mark J Ferris National Institute on Drug Abuse DA006634 Mark J Ferris National Institute on Alcohol Abuse and Alcoholism AA026117 Mark J Ferris National Institute on Alcohol Abuse and Alcoholism AA028162 Elizabeth G Pitts National Institute of General Medical Sciences GM102773 Elizabeth G Pitts Peter McManus Charitable Trust Mark J Ferris National Institute on Drug Abuse	R01DA047368, R01DA045023, R01DA036550, R13DA042568, T32 DA07209, R01DA047391, R01DA048617, K23DA054309, R01DA043938
National Institute on Alcohol Abuse and Alcoholism	R01AA026255, R21AA026129

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

adverse childhood experiences
initiation of substance use
mental illness
opioid use disorder
psychiatry
psychology
substance use
substance use disorder

ASJC Scopus subject areas

Psychiatry and Mental health

Access to Document

10.1177/00912174231195751

Cite this

@article{a14c9b5a845e481f9f862f7205b80cd0,

title = "Adverse childhood experiences and early initiation of substance use: A survival analysis",

abstract = "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.",

keywords = "adverse childhood experiences, initiation of substance use, mental illness, opioid use disorder, psychiatry, psychology, substance use, substance use disorder",

author = "Meadows, \{Amy L.\} and Strickland, \{Justin C.\} and Hyder, \{S. Maela\} and Basconi, \{Rita C.\} and Stull, \{Margaret E.\} and Wagner, \{Frances P.\} and Nguyen, \{Mai N.\} and Rayapati, \{Abner O.\} and Rush, \{Craig R.\}",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2023.",

year = "2024",

month = mar,

doi = "10.1177/00912174231195751",

language = "English",

volume = "59",

pages = "218--231",

number = "2",

}

TY - JOUR

T1 - Adverse childhood experiences and early initiation of substance use

T2 - A survival analysis

AU - Meadows, Amy L.

AU - Strickland, Justin C.

AU - Hyder, S. Maela

AU - Basconi, Rita C.

AU - Stull, Margaret E.

AU - Wagner, Frances P.

AU - Nguyen, Mai N.

AU - Rayapati, Abner O.

AU - Rush, Craig R.

N1 - Publisher Copyright: © The Author(s) 2023.

PY - 2024/3

Y1 - 2024/3

N2 - 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.

AB - 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.

KW - adverse childhood experiences

KW - initiation of substance use

KW - mental illness

KW - opioid use disorder

KW - psychiatry

KW - psychology

KW - substance use

KW - substance use disorder

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UR - https://www.scopus.com/pages/publications/85168454993#tab=citedBy

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DO - 10.1177/00912174231195751

M3 - Article

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AN - SCOPUS:85168454993

SN - 0091-2174

VL - 59

SP - 218

EP - 231

JO - International Journal of Psychiatry in Medicine

JF - International Journal of Psychiatry in Medicine

IS - 2

ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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