Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting
Background: Adverse childhood experiences (ACEs) and substance use disorders (SUDs) are highly prevalent public health challenges that have been shown to be strongly correlated. Although previous research has suggested a dose-response relationship between ACEs and SUDs, less is known about this phen...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Addictive Behaviors Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352853220301085 |
| _version_ | 1818594501971673088 |
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| author | Daniel J. Bryant Emil N. Coman April Joy Damian |
| author_facet | Daniel J. Bryant Emil N. Coman April Joy Damian |
| author_sort | Daniel J. Bryant |
| collection | DOAJ |
| description | Background: Adverse childhood experiences (ACEs) and substance use disorders (SUDs) are highly prevalent public health challenges that have been shown to be strongly correlated. Although previous research has suggested a dose-response relationship between ACEs and SUDs, less is known about this phenomenon and the prevalence of ACEs in lower income, racially/ethnically diverse populations. This study sought to examine these relationships in a population treated at a multi-site safety net provider. Methods: The ACEs survey was delivered as a standard assessment to all behavioral health patients seen at a large Federally Qualified Health Center (FQHC) in Connecticut. 4378 patients completed the questionnaire. Both total score and individual ACE questions were correlated with diagnostic history, according to chi-square and multiple-group structural equation modeling tests. Results: 84.8% of patients reported at least one ACE and 49.1% had an ACE score ≥ 4. Experiencing 1 or more ACEs predicted having any SUD, after controlling for race/ethnicity and gender. Parent substance use, physical abuse, and sexual abuse in particular were the strongest predictors of developing any SUD. Men and non-white individuals were more likely to develop an SUD with lower ACE scores than women and white individuals. Conclusions: While ACEs predict an increased likelihood of developing any SUD, the nature of this relationship differs by both gender and race/ethnicity. In this FQHC patient population there is no obvious dose-response relationship between ACEs and SUDs. Additional research is required to help understand why the relationship between ACEs and SUDs observed here differs from other populations. |
| first_indexed | 2024-12-16T11:01:08Z |
| format | Article |
| id | doaj.art-671352ebb3c94f8897878c198620bf1d |
| institution | Directory Open Access Journal |
| issn | 2352-8532 |
| language | English |
| last_indexed | 2024-12-16T11:01:08Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Addictive Behaviors Reports |
| spelling | doaj.art-671352ebb3c94f8897878c198620bf1d2022-12-21T22:33:59ZengElsevierAddictive Behaviors Reports2352-85322020-12-0112100293Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare settingDaniel J. Bryant0Emil N. Coman1April Joy Damian2Weitzman Institute at Community Health Center, Inc., 19 Grand Street, Middletown, CT 06457, United States; Corresponding author.University of Connecticut Health Disparities Institute, 263 Farmington Ave., MC 7030, Farmington, CT 06030-7030, United StatesWeitzman Institute at Community Health Center, Inc., 19 Grand Street, Middletown, CT 06457, United StatesBackground: Adverse childhood experiences (ACEs) and substance use disorders (SUDs) are highly prevalent public health challenges that have been shown to be strongly correlated. Although previous research has suggested a dose-response relationship between ACEs and SUDs, less is known about this phenomenon and the prevalence of ACEs in lower income, racially/ethnically diverse populations. This study sought to examine these relationships in a population treated at a multi-site safety net provider. Methods: The ACEs survey was delivered as a standard assessment to all behavioral health patients seen at a large Federally Qualified Health Center (FQHC) in Connecticut. 4378 patients completed the questionnaire. Both total score and individual ACE questions were correlated with diagnostic history, according to chi-square and multiple-group structural equation modeling tests. Results: 84.8% of patients reported at least one ACE and 49.1% had an ACE score ≥ 4. Experiencing 1 or more ACEs predicted having any SUD, after controlling for race/ethnicity and gender. Parent substance use, physical abuse, and sexual abuse in particular were the strongest predictors of developing any SUD. Men and non-white individuals were more likely to develop an SUD with lower ACE scores than women and white individuals. Conclusions: While ACEs predict an increased likelihood of developing any SUD, the nature of this relationship differs by both gender and race/ethnicity. In this FQHC patient population there is no obvious dose-response relationship between ACEs and SUDs. Additional research is required to help understand why the relationship between ACEs and SUDs observed here differs from other populations.http://www.sciencedirect.com/science/article/pii/S2352853220301085Adverse Childhood Experiences (ACEs)TraumaSubstance use disordersCommunity health |
| spellingShingle | Daniel J. Bryant Emil N. Coman April Joy Damian Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting Addictive Behaviors Reports Adverse Childhood Experiences (ACEs) Trauma Substance use disorders Community health |
| title | Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting |
| title_full | Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting |
| title_fullStr | Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting |
| title_full_unstemmed | Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting |
| title_short | Association of adverse childhood experiences (ACEs) and substance use disorders (SUDs) in a multi-site safety net healthcare setting |
| title_sort | association of adverse childhood experiences aces and substance use disorders suds in a multi site safety net healthcare setting |
| topic | Adverse Childhood Experiences (ACEs) Trauma Substance use disorders Community health |
| url | http://www.sciencedirect.com/science/article/pii/S2352853220301085 |
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