Association Between Adverse Childhood Experiences and Opioid Use-Related Behaviors: A Systematic Review
Abstract
As opioid use-related behaviors continue at epidemic proportions, identifying the root causes of these behaviors is critical. Adverse childhood experiences (ACEs) are shown to be an important predictor of opioid initiation, opioid dependence, and lifetime opioid overdose. The purpose of this systematic review is to examine the association between ACEs and opioid use-related behaviors later in life and to discuss implications for policy, practice, and research regarding ACEs and opioids. Five databases (PubMed, PsycINFO, CINAHL, Medline, and Scopus) were used to identify studies investigating the association between ACEs and opioid use-related behaviors. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 20 studies out of the initial 428 met the inclusion criteria for this review. Among the included 20 studies, 15 focused on the relationship between ACEs and lifetime opioid use-related behaviors, and five focused on current opioid use-related behaviors. All studies found statistical associations between ACEs and lifetime or current opioid use-related behaviors. Five studies found a significant gradient effect; that is, as the number of ACEs increased, the risk of opioid use-related behaviors also increased. A significant dose–response relationship exists between ACEs and opioid use-related behaviors. Hence, it is essential for clinicians to screen for ACEs before prescribing opioid medications, for opioid treatment to incorporate trauma-informed methods, and for messaging around opioid use interventions to include information about ACEs. The current review points to a critical need to implement standardized ACE screening instruments in clinical and research settings.
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Biographies
Sanjaya Regmi, PhD (c), MPH, is a doctoral candidate in Social and Behavioral Sciences at the University of Memphis School of Public Health. His dissertation research focuses on the role of resilience after adverse childhood experiences (ACEs) among children and adolescents. He is an experienced public health practitioner with nearly ten years of experience working in Nepal, India, and the United States. He is interested in ACEs, substance use prevention, and mental health promotion among children and adolescents.
Satish K. Kedia, PhD, MPH, MS, is the Associate Dean of Administration and Faculty Affairs, and Professor of Social and Behavioral Sciences at the University of Memphis School of Public Health. His extensive research career has focused on addiction issues, substance use prevention and treatment, harm reduction, cancer, and caregiving and adherence. He has over two decades of experience managing and analyzing national and state-level data for many research and evaluation projects using mixed methods research.
Nikhil A. Ahuja, PhD, MDS, BDS, is an Assistant Professor in the Department of Public Health at the Slippery Rock University of Pennsylvania. He has over 8 years of public health teaching, research, and practice experience in culturally diverse, interdisciplinary settings. His research focuses on tobacco control, including epidemiological, behavioral, environmental, policy, and cessation/prevention efforts; substance abuse prevention and treatment; and oral cancer and oral disease screening and prevention.
Guijin Lee, PhD, MSW, is a postdoctoral research fellow in the Divisions of Social and Behavioral Sciences at the University of Memphis School of Public Health. She is interested in developing and evaluating substance use and mental health treatment programs through community-engaged research. She received her doctorate at the Ohio State University College of Social Work and completed a postdoctoral research fellowship at Wayne State University School of Social Work.
Coree Entwistle, BA, is a community advocate for public health improvement through the non-profit and NGO sectors. Over the last 5 years, she has been working with Dr. Satish Kedia and a team of collaborators to examine various aspects of opioid and other substance use treatment, overdose, and harm reduction strategies among vulnerable populations including homeless, ex-offender women, and veterans in Tennessee’s rural communities using qualitative and mixed methods research.
Patrick J. Dillon, PhD, is an Associate Professor in the School of Communication Studies at Kent State University; he is a resident faculty member at the KSU Stark Campus, where he also serves as Academic Program Coordinator for the College of Communication and Information. His research focuses on exploring health inequality in contemporary society, with a specific emphasis on end-of-life care, HIV/AIDS, and substance use disorders.
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Article first published online: November 3, 2023
Issue published: July 2024
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PubMed: 37920999
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- Childhood and Prenatal Stressors Shape Breastfeeding Behavior in Individuals with Opioid Use Disorder: A Prospective Investigation of Stress Effects
- Understanding Opioid Use from Retrospective Accounts of Young Adults in Recovery: Motives, Experiences, and Implications for Prevention
- Opioid Use Disorder in Older Adults: a Narrative Review
- Positive childhood experiences in mental health of young adults across adverse childhood experiences levels: A study from Delhi-NCR, India
- Impact of adverse childhood experiences on analgesia-related outcomes: a systematic review
- Local Supports to Break the Cycle: A Description of Intersectional Interventions to Address Adverse Childhood Experiences and Drug Overdose
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