Adverse childhood experiences and at-risk drinking, cannabis, and illicit drug use

New research from the Prevention Research Center of the Pacific Institute for Research and Evaluation suggests that adverse childhood experiences, often referred to as child maltreatment, are associated with increased odds of substance use among women urban Emergency Department (ED) patients.

To study the question, the research scientists used a cross-sectional survey with 1,037 married or partnered ED patients at a public safety-net hospital that gathered information about at-risk drinking, cannabis, and illicit drug use. As a safety-net hospital, most of the patients seeking medical care are of low socio-economic status, and most are African American or Hispanic.

Adverse childhood experiences were measured as:

• exposure to a mentally ill person in the home
• parent/caregiver alcoholism
• sexual abuse
• physical abuse
• psychological abuse
• violence directed against the respondent's mother

The results showed that at least one adverse childhood experience was reported by 53% of men and 60% of women. Moreover:

• Women whose mothers were victims of domestic violence had greater chances of at-risk drinking,
• Women with multiple adverse experiences were more likely to use cannabis,
• Women with multiple adverse experiences were more likely use illicit drugs.

Men's individual or multiple adverse childhood experiences were not associated with increased likelihood for any of the outcomes.

Says lead author, Dr. Carol Cunradi: "Health disparities are pervasive among underserved populations, such as those seeking care at urban EDs. So it is important to understand how adverse childhood experiences are linked with substance use among urban ER patients. The prevalence of exposure to childhood maltreatment in this urban ED sample underscores the importance of ED staff providing trauma-informed care to patients, including the delivery of brief interventions and referral to treatment."