How childhood adversity may influence risks for drugs and alcohol

Adverse childhood experiences (ACEs) are known to increase the risk of substance use problems later in life. New research from George Mason University’s College of Public Health suggests that the specific types of adversity a young person faces may be associated with different vulnerabilities to those risks. 

The study, led by Social Work Professor Sunny Shin, examined patterns of ACEs among young adults and their relationship to factors associated with substance use disorders, including hopelessness, impulsivity, and cravings for alcohol or drugs in response to both positive and negative emotions. 

Researchers identified three distinct patterns of ACEs exposure: relatively low exposure, a pattern characterized by emotional abuse, and exposure to multiple forms of adversity. The study, published in the Journal of Child & Adolescent Substance Use, found that young adults in the emotional abuse group reported greater hopelessness than those with relatively few ACEs, while those exposed to multiple forms of adversity reported stronger cravings for alcohol or drugs during negative emotions. 

“Understanding these nuanced differences could help us tailor prevention and intervention strategies to individuals’ specific needs,” Shin said. “Someone struggling with hopelessness may benefit from interventions that promote positive coping skills, while someone experiencing substance cravings during emotional distress may benefit from strategies focused on emotion regulation and distress tolerance.” 

Why it matters 

Research on ACEs has traditionally emphasized cumulative risk: As the number of adverse experiences increases, so does vulnerability to a range of health problems later in life, including substance use disorders. 

But two people with the same ACE score may have very different histories. One may have experienced emotional neglect, for example, while another grew up with substance use and mental illness in the home. 

This study’s findings suggest those differences may matter. Looking at patterns of childhood adversity alongside the total number of ACEs could help researchers better understand differences in vulnerability to substance use and develop more targeted prevention strategies. 

More study details 

Researchers studied 221 young adults ages 18 to 21, examining factors linked to substance use risk rather than substance use itself. Among the details: 

• The study examined 10 types of childhood adversity, including abuse and neglect, parental separation or divorce, substance use or mental illness in the home, and household incarceration. Participants reported an average of 2.7 ACEs, while about 23% reported none.
• Young adults with a pattern distinguished by emotional abuse reported greater hopelessness than those with relatively few ACEs. However, hopelessness levels among those exposed to multiple forms of adversity did not differ significantly from those in the other groups.
• Young adults exposed to multiple forms of adversity reported stronger cravings for alcohol or drugs during negative emotions than other groups. The researchers found no significant differences among the groups in cravings during positive emotions.
• The researchers say larger, long-term studies are needed to understand how patterns of childhood adversity may affect substance use over time.