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Koball AM, Ames GE, Grothe K. Role of Adverse Childhood Experiences in the Onset of Overweight/Obesity. Curr Obes Rep 2024; 13:574-583. [PMID: 38874702 DOI: 10.1007/s13679-024-00563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE OF REVIEW The goal of this chapter was to summarize the literature on childhood adversity and obesity, discuss treatment implications with a case example, and provide recommendations for trauma-informed care for clinicians who work with individuals living with obesity. RECENT FINDINGS Adversity in childhood is related directly and indirectly to obesity development. Upstream contributors like adverse childhood experiences (ACEs) and other factors can lead to experiences of toxic stress and increased allostatic load, resulting in downstream effects of obesity and other chronic health conditions. A well-established literature has linked ACEs and obesity suggesting complex interactions between genetic, biological, behavioral, mental health, social, and environmental factors and obesity. Trauma-informed care strategies can be used to optimize care for individuals living with obesity. Care pathways should include individual (clinician) and systemic (organizational) evidence-based interventions.
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Affiliation(s)
| | - Gretchen E Ames
- Mayo Clinic Florida, 4500 San Pablo Rd S, Jacksonville, FL, 32224, USA
| | - Karen Grothe
- Mayo Clinic, 200 1st SW, Rochester, MN, 55905, USA
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Kapp JM, Dicke R, Quinn K. Online Delivery of Interprofessional Adverse Childhood Experiences Training to Rural Providers: Usability Study. JMIR Pediatr Parent 2024; 7:e56722. [PMID: 39132681 PMCID: PMC11317445 DOI: 10.2196/56722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/03/2024] [Accepted: 06/11/2024] [Indexed: 08/13/2024] Open
Abstract
Background The population health burden of adverse childhood experiences (ACEs) reflects a critical need for evidence-based provider training. Rural children are also more likely than urban children to have any ACEs. A large proportion of providers are unaware of the detrimental effects of ACEs. There is a significant documented need for training providers about ACEs and trauma-informed care, in addition to a demand for that training. Objective The objective was to develop, implement, and evaluate an online ACEs training curriculum tailored to Missouri providers, particularly those in rural areas given the higher prevalence of ACEs. Methods From July 2021 to June 2022, we conducted literature reviews and environmental scans of training videos, partner organizations, clinical practice guidelines, and community-based resources to curate appropriate and tailored content for the course. We developed the ACEs training course in the Canvas learning platform (Instructure) with the assistance of an instructional designer and media designer. The course was certified for continuing medical education, as well as continuing education for licensed professional counselors, psychologists, and social workers. Recruitment occurred via key stakeholder email invitations and snowball recruitment. Results Overall, 135 providers across Missouri requested enrollment, with 72.6% (n=98) enrolling and accessing the training. Of the latter, 49% (n=48) completed course requirements, with 100% of respondents agreeing that the content was relevant to their work, life, or practice; they intend to apply the content to their work, life, or practice; they feel confident to do so; and they would recommend the course to others. Qualitative responses supported active intent to translate knowledge into practice. Conclusions This study demonstrated the feasibility, acceptability, and effectiveness of interprofessional workforce ACEs training. Robust interest statewide reflects recognition of the topic's importance and intention to translate knowledge into practice.
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Affiliation(s)
- Julie M Kapp
- Department of Public Health, College of Health Sciences, University of Missouri, 806 Lewis Hall, Columbia, MO, 65201, United States, 1 5738843684
| | - Rachel Dicke
- Institute of Public Policy, Truman School of Government and Public Affairs, University of Missouri, Columbia, MO, United States
| | - Kathleen Quinn
- School of Medicine, University of Missouri, Columbia, MO, United States
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Benton M, Dicke R, Kapp JM. Interprofessional perspectives on ACEs: Results from a statewide interprofessional training program. CHILD ABUSE & NEGLECT 2024; 154:106911. [PMID: 38943769 DOI: 10.1016/j.chiabu.2024.106911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 05/29/2024] [Accepted: 06/12/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are pervasive and well-recognized as having lasting deleterious effects on the physical and mental health of those who experience them, particularly with accumulated exposure. OBJECTIVE This study seeks to identify the perspectives of interprofessional health providers on their personal and professional experiences with ACEs, ACEs screening, how to work with people with ACEs, and make recommendations for the field. PARTICIPANTS AND SETTING Sixty-two health professionals and PhD students who completed at least one module of an online course and at least one of the accompanying discussion board sub-prompts. METHODS Responses to five course discussion board assignments, each with multiple sub-prompts, were coded to determine and refine major themes and merged with demographic and other background data. From the 561 responses, six themes were identified and used to analyze response patterns. RESULTS Twenty-nine percent of responses reflected a macro perspective on ACEs; 29 % of responses reflected workplace experiences; 28 % of responses reflected ACEs complexity, 8 % of responses reflected a personal relationship to ACEs, 3 % reflected perspectives on resilience; and 3 % were related to the course. Participants communicated complex understandings of ACEs, demonstrating the relevance and importance of the topic for public health training. CONCLUSIONS Integrating ACEs training into the practice setting provides opportunities to improve the health and lives of those suffering from ACEs, especially when incorporating provider voice and perspectives.
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Affiliation(s)
- Mark Benton
- Center for Health Policy, Department of Public Health, College of Health Sciences, University of Missouri, United States of America.
| | - Rachel Dicke
- Institute of Public Policy, Truman School of Government and Public Affairs, University of Missouri, United States of America
| | - Julie M Kapp
- Department of Public Health, College of Health Sciences, University of Missouri, United States of America
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Regmi S, Kedia SK, Ahuja NA, Lee G, Entwistle C, Dillon PJ. Association Between Adverse Childhood Experiences and Opioid Use-Related Behaviors: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:2046-2064. [PMID: 37920999 DOI: 10.1177/15248380231205821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
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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Assini-Meytin LC, Giacomozzi AI, Priolo Filho SR, Lorandi JM, Laurinaitytė I. Adverse Childhood Experiences in Brazilian College Students: Examining Associations with Suicidal Ideation and Risky Behaviors. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:495-505. [PMID: 38938942 PMCID: PMC11199450 DOI: 10.1007/s40653-023-00572-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 06/29/2024]
Abstract
Background The association between adverse childhood experiences (ACEs) and poor health outcomes is well-established in high-income countries. However, the evidence is limited for the association of ACEs, mental health, and risky behaviors for low- and middle-income countries. Moreover, studies often overlook prescription drug misuse and risky driving when examining the association of ACEs with risky behaviors. In our study, we examined the associations between ACEs, suicidal ideation, and risky behaviors (binge drinking, prescription drug misuse, and risky driving) among Brazilian college students. Methods Participants consisted of a convenience sample of students recruited from undergraduate courses primarily in two states in Southern Brazil (93%). Data were collected via an online survey between December 2020 and August 2021. The analytical sample comprised 503 participants, most were female (71%), and the mean age was 24 years. Survey instrument included questions on ten different ACE types, mental health, and risky behaviors. Statistical analyses included univariate descriptive analysis, binary and multivariable regression models. Results Across the ten ACE types assessed, only 14% of participants reported no ACEs, and 29% of participants experienced polyvictimization (i.e., four or more ACES). Multivariable models showed that, compared to those with no ACEs, participants who experienced polyvictimization had significantly increased odds of reporting suicide ideation (AOR = 6.21, p < .001), prescription drug misuse (AOR = 8.78, p < .01), and riding with an impaired driver (AOR = 3.58, p < .01). Conclusions Our findings support the need for psychological support and services available for college students with multiple ACEs.
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Affiliation(s)
- Luciana C. Assini-Meytin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 415 N. Washington Street, Baltimore, MD 21231 USA
| | - Andreia Isabel Giacomozzi
- Department of Psychology, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, Trindade, Florianópolis, SC 88040-900 Brasil
| | - Sidnei R. Priolo Filho
- Laboratório de Pesquisa, Prevenção e Intervenção em Psicologia Forense, Universidade Tuiuti do Paraná – Rua Sydney Rangel Santos, Curitiba/PR, 238 Brasil
| | - Joana Milan Lorandi
- Department of Psychology, Federal University of Santa Catarina, R. Eng. Agronômico Andrei Cristian Ferreira, Trindade, Florianópolis, SC 88040-900 Brasil
| | - Ilona Laurinaitytė
- Institute of Psychology, Vilnius University, Universiteto g. 9/1, Vilnius, 01513 Lithuania
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Sampasa-Kanyinga H, Chaput JP, Mougharbel F, Hamilton HA. Associations between cannabis use, opioid misuse and severe psychological distress in adolescents: A cross-sectional school-based study. Drug Alcohol Depend 2024; 255:111085. [PMID: 38228057 DOI: 10.1016/j.drugalcdep.2024.111085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Cannabis use and nonmedical use of prescription opioids are consumed by a small to moderate number of adolescents. However, little is known about their combined influence on mental health in this age group. This study examined the association between cannabis use, nonmedical use of prescription opioids, or both with serious psychological distress among adolescents and tested if sex could moderate these associations. METHODS We based our analyses on cross-sectional data from the 2019 Ontario Student Drug Use and Health Survey, a provincially representative sample of students in grades 7 through 12 (aged 11-20 years or older) across Ontario, Canada (n= 7097; mean age: 15.2 ± 1.2 years). Logistic regression analyses were adjusted for important covariates. RESULTS We found that 20.5% reported cannabis use only, 5.8% reported opioid use only, and 5% reported both cannabis and opioid use. Cannabis use only (odds ratio [OR]:1.91; 95% confidence interval [CI]:1.53-2.37), opioid use only (OR: 2.21; 95% CI: 1.63-3.00), and both cannabis and opioid use (OR: 3.24; 95% CI: 2.25-4.66) were associated with greater odds of serious psychological distress after adjustment for covariates. Associations were similar for males and females. CONCLUSION The use of both cannabis and opioids is significantly associated with serious psychological distress among adolescents. Adolescents who use both cannabis and opioids represent a small and vulnerable group that should be targeted in future interventions against mental health problems. Health professionals should consider screening for polysubstance use, especially when working with adolescents who use cannabis.
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Affiliation(s)
- Hugues Sampasa-Kanyinga
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Fatima Mougharbel
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Hayley A Hamilton
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Rhodes CA, Thomas N, O'Hara KL, Hita L, Blake A, Wolchik SA, Fisher B, Freeman M, Chen D, Berkel C. Enhancing the Focus: How Does Parental Incarceration Fit into the Overall Picture of Adverse Childhood Experiences (ACEs) and Positive Childhood Experiences (PCEs)? Res Child Adolesc Psychopathol 2023; 51:1933-1944. [PMID: 37875642 PMCID: PMC11008286 DOI: 10.1007/s10802-023-01142-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/26/2023]
Abstract
Despite the five million children in the U.S. with an incarcerated parent, there is limited research on risk and protective factors for this population. We analyzed data from the National Survey for Children's Health (2018) to: (1) examine associations among parental incarceration and other adverse childhood experiences (ACEs), (2) characterize the association between parental incarceration and youth mental health outcomes, (3) examine differences in positive childhood experiences (PCEs; collective socialization, community engagement, neighborhood amenities, and family problem solving) by parental incarceration status, (4) examine whether PCEs were protective against mental health problems and if there was an interaction with parental incarceration status, and (5) examine the interaction between PCEs, parental incarceration, and ACEs on mental health problems. Results revealed that children with incarcerated parents had higher odds of experiencing other ACEs, higher odds of having mental health problems, and experienced fewer PCEs compared to children without incarcerated parents. Further, although PCEs were associated with a lower odds of mental health problems for both children with and without incarcerated parents, they did not mitigate the negative impact of parental incarceration on mental health outcomes. While PCEs attenuated the association between ACEs and mental health, parental incarceration status did not significantly moderate the interaction. These results highlight vulnerabilities and potential protective factors for children with incarcerated parents and have important implications for the development of multilevel intervention strategies that seek to promote resilience and reduce risk for this population.
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Affiliation(s)
| | - N Thomas
- Arizona State University, Tempe, USA
| | | | - L Hita
- Arizona State University, Tempe, USA
| | - A Blake
- Arizona State University, Tempe, USA
| | | | - B Fisher
- Arizona State University, Tempe, USA
| | - M Freeman
- Arizona State University, Tempe, USA
| | - D Chen
- Arizona State University, Tempe, USA
| | - C Berkel
- Arizona State University, Tempe, USA
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Halphen JM, Arthur JA, Pacheco S, Nguyen LMT, Samy NN, Wilson NR, Sattler G, Wing SE, Paulino RAD, Feng C, Shah P, Olayiwola S, Cannell B, Addimulam S, Patel R, Hui D. Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic. Cancers (Basel) 2023; 15:5663. [PMID: 38067365 PMCID: PMC10705126 DOI: 10.3390/cancers15235663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Few studies have examined the use of immunoassay urine drug testing of cancer patients in palliative care clinics. OBJECTIVES We examined the frequency of immunoassay urine drug test (UDT) abnormalities and the factors associated with aberrancy at a safety-net hospital palliative medicine clinic. METHODS A retrospective review of the electronic medical records of consecutive eligible patients seen at the outpatient palliative medicine clinic in a resource-limited safety-net hospital system was conducted between 1 September 2015 and 31 December 2020. We collected longitudinal data on patient demographics, UDT findings, and potential predictors of aberrant results. RESULTS Of the 913 patients in the study, 500 (55%) underwent UDT testing, with 455 (50%) having the testing within the first three visits. Among those tested within the first three visits, 125 (27%) had aberrant UDT results; 44 (35%) of these 125 patients were positive for cocaine. In a multivariable regression model analysis of predictors for aberrant UDT within the first three visits, non-Hispanic White race (odds ratio (OR) = 2.13; 95% confidence interval (CI): 1.03-4.38; p = 0.04), history of illicit drug use (OR = 3.57; CI: 1.78-7.13; p < 0.001), and history of marijuana use (OR = 7.05; CI: 3.85-12.91; p < 0.001) were independent predictors of an aberrant UDT finding. CONCLUSION Despite limitations of immunoassay UDT, it was able to detect aberrant drug-taking behaviors in a significant number of patients seen at a safety-net hospital palliative care clinic, including cocaine use. These findings support universal UDT monitoring and utility of immunoassay-based UDT in resource-limited settings.
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Affiliation(s)
- John M. Halphen
- Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA; (S.P.); (L.M.T.N.); (S.O.)
| | - Joseph A. Arthur
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (J.A.A.); (D.H.)
| | - Soraira Pacheco
- Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA; (S.P.); (L.M.T.N.); (S.O.)
| | - Linh M. T. Nguyen
- Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA; (S.P.); (L.M.T.N.); (S.O.)
| | - Nikitha N. Samy
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Nathaniel R. Wilson
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Gregory Sattler
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Shane E. Wing
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Rex A. D. Paulino
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Christine Feng
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Pulin Shah
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA (N.R.W.); (G.S.); (S.E.W.); (R.A.D.P.)
| | - Simbiat Olayiwola
- Joan and Stanford Alexander Division of Geriatric and Palliative Medicine, McGovern Medical School, UTHealth, Houston, TX 77030, USA; (S.P.); (L.M.T.N.); (S.O.)
| | - Bradley Cannell
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.C.); (S.A.); (R.P.)
| | - Supriyanka Addimulam
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.C.); (S.A.); (R.P.)
| | - Riddhi Patel
- Department of Epidemiology, Human Genetics & Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; (B.C.); (S.A.); (R.P.)
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (J.A.A.); (D.H.)
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Diedrick M, Clements-Nolle K, Anderson M, Yang W. Adverse childhood experiences and clustering of high-risk behaviors among high school students: a cross-sectional study. Public Health 2023; 221:39-45. [PMID: 37393751 DOI: 10.1016/j.puhe.2023.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/17/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES This study assessed the association between adverse childhood experiences (ACEs) and clustering of high-risk behaviors in a sample of high school students. STUDY DESIGN This was a cross-sectional study. METHODS A sample of students who attended randomly selected classes in 99 high schools completed the 2019 Nevada Youth Risk Behavior Survey (N = 4959). The survey included six ACE measures: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) household physical abuse, (5) household mental illness, and (6) household substance abuse. Students were assigned a cumulative ACE score (range = 0-6). A count of high-risk behavior domains was created using multiple questions across the following domains: (1) violence behaviors, (2) suicidal indicators, (3) non-suicidal self-injury, (4) substance use, (5) high-risk sexual behaviors, (6) poor diet, (7) physical inactivity, and (8) high screen time (range = 0-8). The relationship between ACEs and the count of high-risk behavior domains was assessed using weighted negative binomial regression; incidence rate ratios (IRRs) were calculated adjusting for sociodemographic characteristics. RESULTS More than 40% of the sampled students reported high-risk behaviors across two or more domains. There was a strong, graded relationship between cumulative ACE score and the count of high-risk behavior domains. Compared with students who experienced zero ACEs, there was an increase in the count of high-risk behavior domains among students who experienced one ACE (adjusted IRR [aIRR] = 1.22, 95% confidence interval [CI] = 1.12-1.33), two ACEs (aIRR = 1.57, 95% CI = 1.42-1.73), three ACEs (aIRR = 1.73, 95% CI = 1.54-1.94), four ACEs (aIRR = 2.07, 95% CI = 1.84-2.33), five ACEs (aIRR = 2.69, 95% CI = 2.34-3.10), and six ACEs (aIRR = 2.91, 95% CI = 2.34-3.62). CONCLUSION Trauma-informed prevention efforts may be an efficient way to address multiple adolescent risk behaviors that cluster.
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Affiliation(s)
- M Diedrick
- University of Nevada, Reno School of Public Health, United States
| | - K Clements-Nolle
- University of Nevada, Reno School of Public Health, United States.
| | - M Anderson
- University of Nevada, Reno School of Public Health, United States
| | - W Yang
- University of Nevada, Reno School of Public Health, United States
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Xiao W, Li S, Xu H, Zhang Y, Wei R, Tao F, Wan Y. Population attributable fractions of adverse childhood experiences for emotional problems and self-harming behaviors among middle school students in China. Asian J Psychiatr 2023; 85:103621. [PMID: 37201384 DOI: 10.1016/j.ajp.2023.103621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 04/24/2023] [Accepted: 05/06/2023] [Indexed: 05/20/2023]
Abstract
The population attributable fractions of health outcomes attributed to adverse childhood experiences (ACEs) among Chinese middle school students is unknown. Of all the 22,868 middle school students, 29.8 % had exposure to four or more ACEs. Findings showed a graded relationship between ACE scores and those adverse outcomes. The PAFs of six outcomes attributed to experiencing ≥ 4 ACEs ranged from 23.1 % to 44.2 %. The results emphasized the significance of preventive interventions to alleviate the negative legacies of ACEs.
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Affiliation(s)
- Wan Xiao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Shuqin Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China
| | - Yi Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Ruihong Wei
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China.
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Anhui, China.
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Fuss C, Romm KF, Crawford ND, Harrington KRV, Wang Y, Ma Y, Taggart T, Ruiz MS, Berg CJ. Psychosocial Correlates of Opioid Use Profiles among Young Adults in a Longitudinal Study across 6 US Metropolitan Areas. Subst Use Misuse 2023; 58:981-988. [PMID: 37082785 PMCID: PMC10645480 DOI: 10.1080/10826084.2023.2201839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Background: Examining opioid use profiles over time and related factors among young adults is crucial to informing prevention efforts. Objectives: This study analyzed baseline data (Fall 2018) and one-year follow-up data from a cohort of 2,975 US young adults (Mage=24.55, 42.1% male; 71.7% White; 11.4% Hispanic). Multinomial logistic regression was used to examine: 1) psychosocial correlates (i.e. adverse childhood experiences [ACEs], depressive symptoms, parental substance use) of lifetime opioid use (i.e. prescription use vs. nonuse, nonmedical prescription [NMPO] use, and heroin use, respectively); and 2) psychosocial correlates and baseline lifetime use in relation to past 6-month use at one-year follow-up (i.e. prescription use vs. nonuse and NMPO/heroin use, respectively). Results: At baseline, lifetime use prevalence was: 30.2% prescription, 9.7% NMPO, and 3.1% heroin; past 6-month use prevalence was: 7.6% prescription, 2.5% NMPO, and 0.9% heroin. Compared to prescription users, nonusers reported fewer ACEs and having parents more likely to use tobacco, but less likely alcohol; NMPO users did not differ; and heroin users reported more ACEs and having parents more likely to use cannabis but less likely alcohol. At one-year follow-up, past 6-month use prevalence was: 4.3% prescription, 1.3% NMPO, and 1.4% heroin; relative to prescription users, nonusers were less likely to report baseline lifetime opioid use and reported fewer ACEs, and NMPO/heroin users were less likely to report baseline prescription opioid use but more likely heroin use. Conclusions: Psychosocial factors differentially correlate with young adult opioid use profiles, and thus may inform targeted interventions addressing different use patterns and psychosocial risk factors.
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Affiliation(s)
- Caroline Fuss
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Katelyn F Romm
- TSET Health Promotion Research Center, Stephenson Cancer Center, Department of Pediatrics, College of Medicine,University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Natalie D Crawford
- Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Kristin R V Harrington
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yan Wang
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Yan Ma
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tamara Taggart
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Monica S Ruiz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Carla J Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- GW Cancer Center, George Washington University, Washington, DC, USA
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12
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Silverstein SM, Rivera J, Gainer D, Daniulaityte R. ‘Things that you can't really suppress': Adverse childhood experiences in the narratives of people with opioid use disorder. SSM - MENTAL HEALTH 2023. [DOI: 10.1016/j.ssmmh.2022.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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13
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Dunn KE, Turner GM, Oswald LM. Effects of Early Life Trauma on Risks for Adult Opioid Use Disorder Are Mediated by Stress and Occur Independent of Depression and Anxiety. J Addict Med 2022; 16:709-715. [PMID: 35914024 PMCID: PMC10834051 DOI: 10.1097/adm.0000000000001011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Adverse childhood experiences, or early life trauma (ELT), may be a potential risk factor for opioid use disorders (OUDs) that could be further influenced by depression, anxiety, and stress. The prevalence and strength of these associations are largely unknown. METHODS This study examined the association between current OUD severity and lifetime history of ELT, and the degree to which current depression, anxiety, and stress influenced this association, in persons (n = 310) with at least 1 lifetime exposure to opioids using an online survey. RESULTS Ninety-three percent of respondents experienced at least 1 trauma in their lifetime, and 65% met the criteria for OUD. Early life trauma was largely unassociated with demographics but demonstrated an almost "dose-dependent" association among all forms of ELT (total, general, physical, emotional, sexual), whereby more ELT was associated with more severe current OUD. A multivariate mediation model found perceived stress to be a robust mediator of this association. Current psychiatric functioning did not significantly moderate the relationship between ELT and OUD, suggesting that ELT may impact OUD severity at varying levels of psychiatric functioning. CONCLUSIONS These data support existing evidence that greater ELT may influence adult OUD severity and identify perceived stress as a potential mechanistic contributor to this association. Results are preliminary in nature but support continued research into mechanisms underlying the association between ELT and OUD, particularly conformational changes in the stress system resultant from ELT, and interventions to mitigate the impact of ELT on OUD development and/or develop trauma-informed OUD treatment approaches.
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Affiliation(s)
- Kelly E Dunn
- From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD (KED, GMT); and Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD (LMO)
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14
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Wisdom AC, Govindu M, Liu SJ, Meyers CM, Mellerson JL, Gervin DW, DePadilla L, Holland KM. Adverse Childhood Experiences and Overdose: Lessons From Overdose Data to Action. Am J Prev Med 2022; 62:S40-S46. [PMID: 35597582 PMCID: PMC9761611 DOI: 10.1016/j.amepre.2021.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Adverse childhood experiences and overdose are linked in a cycle that affects individuals and communities across generations. The Centers for Disease Control and Prevention's Overdose Data to Action cooperative agreement supports a comprehensive public health approach to overdose prevention and response activities across the U.S. Exposure to traumatic events during childhood can increase the risk for myriad health outcomes, including overdose; therefore, many Overdose Data to Action recipients leveraged funds to address adverse childhood experiences. METHODS In 2021, an inventory of Overdose Data to Action‒funded activities implemented in 2019 and 2020 showed that 34 of the 66 recipients proposed overdose prevention activities that support people who have experienced adverse childhood experiences or that focus on preventing the intergenerational transmission of adverse childhood experiences. Activities were coded by adverse childhood experience prevention strategy, level of the social ecology, and whether they focused on neonatal abstinence syndrome. RESULTS Most activities among Overdose Data to Action recipients occurred at the community level of the social‒ecologic model and under the intervene to lessen harms adverse childhood experience prevention strategy. Of the 84 adverse childhood experience‒related activities taking place across 34 jurisdictions, 44 are focused on neonatal abstinence syndrome. CONCLUSIONS Study results highlight the opportunities to expand the breadth of adverse childhood experience prevention strategies across the social ecology. Implementing cross-cutting overdose and adverse childhood experience‒related activities that span the social‒ecologic model are critical for population-level change and have the potential for the broadest impact. Focusing on neonatal abstinence syndrome also offers a unique intervention opportunity for both adverse childhood experience and overdose prevention.
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Affiliation(s)
- April C Wisdom
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Madhumita Govindu
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen J Liu
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina M Meyers
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jenelle L Mellerson
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Derrick W Gervin
- Extramural Research Operations, National Center for Injury Prevention and Control, National Center for Environmental Health, Agency for Toxic Substances and Disease Registry, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lara DePadilla
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kristin M Holland
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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15
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Sex differences in the association of adverse childhood experiences on past 30-day opioid misuse among Florida justice-involved children. J Subst Abuse Treat 2022; 140:108787. [DOI: 10.1016/j.jsat.2022.108787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/06/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022]
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16
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Jones CM, Houry D, Han B, Baldwin G, Vivolo-Kantor A, Compton WM. Methamphetamine use in the United States: epidemiological update and implications for prevention, treatment, and harm reduction. Ann N Y Acad Sci 2022; 1508:3-22. [PMID: 34561865 PMCID: PMC9097961 DOI: 10.1111/nyas.14688] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/04/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
Recent attention has focused on the growing role of psychostimulants, such as methamphetamine in overdose deaths. Methamphetamine is an addictive and potent stimulant, and its use is associated with a range of physical and mental health harms, overdose, and mortality. Adding to the complexity of this resurgent methamphetamine threat is the reality that the increases in methamphetamine availability and harms are occurring in the midst of and intertwined with the ongoing opioid overdose crisis. Opioid involvement in psychostimulant-involved overdose deaths increased from 34.5% of overdose deaths in 2010 to 53.5% in 2019-an increase of more than 50%. This latest evolution of the nation's overdose epidemic poses novel challenges for prevention, treatment, and harm reduction. This narrative review synthesizes what is known about changing patterns of methamphetamine use with and without opioids in the United States, other characteristics associated with methamphetamine use, the contributions of the changing illicit drug supply to use patterns and overdose risk, motivations for couse of methamphetamine and opioids, and awareness of exposure to opioids via the illicit methamphetamine supply. Finally, the review summarizes illustrative community and health system strategies and research opportunities to advance prevention, treatment, and harm reduction policies, programs, and practices.
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Affiliation(s)
- Christopher M. Jones
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Debra Houry
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland
| | - Grant Baldwin
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alana Vivolo-Kantor
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland
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17
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Jackson DB, Posick C, Vaughn MG, Testa A. Adverse childhood experiences and traumatic brain injury among adolescents: findings from the 2016-2018 National Survey of Children's Health. Eur Child Adolesc Psychiatry 2022; 31:289-297. [PMID: 33386525 DOI: 10.1007/s00787-020-01687-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
Exposure to adverse childhood experiences (ACEs) is a significant public health issue for youth. However, traumatic brain injury (TBI) has been almost entirely overlooked in the ACEs and health outcomes literature, which has largely focused on the significant mental and behavioral health impact of ACEs. The goal the current study is to examine the association between ACEs and TBI among a nationally representative sample of adolescents in the United States and the extent to which ADHD and conduct problems inform this association. To assess this relationship, we use a sample of 42,204 adolescents (ages 12-17 years) in the United States whose caregivers were surveyed during the three most recent cohorts (2016-2018) of the National Survey of Children's Health (NSCH). The results revealed a dose-response relationship between ACEs and TBI, even after accounting for an array of confounding variables. Findings also indicated that associations were of a greater magnitude among youth who are not sports-involved. Supplemental mediation analyses showed that ADHD and conduct problems attenuated associations between ACE exposure and TBI, but only in the absence of youth sports involvement. Given that both ACEs and TBI carry long-term consequences for health and well-being, the findings from this study draw attention to the need for early intervention and prevention programming (e.g. home visiting) that can reduce the prevalence of ACEs and a history of TBI among adolescents.
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Affiliation(s)
- Dylan B Jackson
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Chad Posick
- Department of Criminal Justice and Criminology, College of Behavioral and Social Sciences, Georgia Southern University, Statesboro, GA, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Alexander Testa
- Department of Criminology and Criminal Justice, College for Health, Community, and Policy, The University of Texas At San Antonio, San Antonio, TX, USA
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18
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Sumner SA, Ferguson B, Bason B, Dink J, Yard E, Hertz M, Hilkert B, Holland K, Mercado-Crespo M, Tang S, Jones CM. Association of Online Risk Factors With Subsequent Youth Suicide-Related Behaviors in the US. JAMA Netw Open 2021; 4:e2125860. [PMID: 34542614 PMCID: PMC8453319 DOI: 10.1001/jamanetworkopen.2021.25860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE The association between online activities and youth suicide is an important issue for parents, clinicians, and policy makers. However, most information exploring potential associations is drawn from survey data and mainly focuses on risk related to overall screen time. OBJECTIVE To evaluate the association between a variety of online risk factors and youth suicide-related behavior using real-world online activity data. DESIGN, SETTING, AND PARTICIPANTS A matched case-control study was conducted from July 27, 2019, to May 26, 2020, with the sample drawn from more than 2600 US schools participating in an online safety monitoring program via the Bark online safety tool. For 227 youths having a severe suicide/self-harm alert requiring notification of school administrators, cases were matched 1:5 to 1135 controls on location, the amount of follow-up time, and general volume of online activity. EXPOSURES Eight potential online risk factors (cyberbullying, violence, drug-related, hate speech, profanity, sexual content, depression, and low-severity self-harm) through assessment of text, image, and video data. MAIN OUTCOMES AND MEASURES Severe suicide/self-harm alert requiring notification of school administrators; severe suicide alerts are statements by youths indicating imminent or recent suicide attempts and/or self-harm. RESULTS The 1362 participants had a mean (SD) age of 13.3 (2.41) years; 699 (51.3%) were male. All 8 online risk factors studied exhibited differences between case and control populations and were significantly associated with subsequent severe suicide/self-harm alerts when examining total direct and indirect pathways. These associations ranged from an adjusted odds ratio (aOR) of 1.17 (95% CI, 1.09-1.26) for drug-related content to an aOR of 1.82 (95% CI, 1.63-2.03) for depression-related content. When considering the total number of different types of online risk factors among the 8 measured, there was an exponentially larger risk of severe suicide/self-harm alerts; youths with 5 or more of the 8 risk factors present in their online activity had a more than 70-fold increased odds of subsequently having a severe suicide/self-harm alert (aOR, 78.64; 95% CI, 34.39-179.84). CONCLUSIONS AND RELEVANCE The findings of this study suggest that many discrete types of risk factors are identifiable from online data and associated with subsequent youth suicide-related behavior. Although each risk factor carries a specific association with suicide-related behavior, the greatest risk is evident for youths demonstrating multiple types of online risk factors.
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Affiliation(s)
- Steven A. Sumner
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Ellen Yard
- Division of Injury Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Marci Hertz
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Kristin Holland
- Division of Overdose Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Melissa Mercado-Crespo
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Shichao Tang
- Division of Violence Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christopher M. Jones
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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19
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Oswald LM, Dunn KE, Seminowicz DA, Storr CL. Early Life Stress and Risks for Opioid Misuse: Review of Data Supporting Neurobiological Underpinnings. J Pers Med 2021; 11:315. [PMID: 33921642 PMCID: PMC8072718 DOI: 10.3390/jpm11040315] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 01/02/2023] Open
Abstract
A robust body of research has shown that traumatic experiences occurring during critical developmental periods of childhood when neuronal plasticity is high increase risks for a spectrum of physical and mental health problems in adulthood, including substance use disorders. However, until recently, relatively few studies had specifically examined the relationships between early life stress (ELS) and opioid use disorder (OUD). Associations with opioid use initiation, injection drug use, overdose, and poor treatment outcome have now been demonstrated. In rodents, ELS has also been shown to increase the euphoric and decrease antinociceptive effects of opioids, but little is known about these processes in humans or about the neurobiological mechanisms that may underlie these relationships. This review aims to establish a theoretical model that highlights the mechanisms by which ELS may alter opioid sensitivity, thereby contributing to future risks for OUD. Alterations induced by ELS in mesocorticolimbic brain circuits, and endogenous opioid and dopamine neurotransmitter systems are described. The limited but provocative evidence linking these alterations with opioid sensitivity and risks for OUD is presented. Overall, the findings suggest that better understanding of these mechanisms holds promise for reducing vulnerability, improving prevention strategies, and prescribing guidelines for high-risk individuals.
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Affiliation(s)
- Lynn M. Oswald
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA;
| | - Kelly E. Dunn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21230, USA;
| | - David A. Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA;
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA;
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20
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Johnson ME, Zaidi F. Sex differences in the effects of physical and sexual abuse on the odds of past 30-day opioid misuse among Florida justice-involved children. ADDICTION RESEARCH & THEORY 2021; 29:479-489. [PMID: 35035335 PMCID: PMC8758115 DOI: 10.1080/16066359.2021.1891414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/12/2021] [Accepted: 02/13/2021] [Indexed: 06/14/2023]
Abstract
AIM Opioid misuse is a severe threat to justice-involved children and adolescents. Identifying risk factors and sex differences is critical to design accurate risk assessments and person-centered interventions. Stress theory and research posit that abuse may be linked to opioid misuse, and the consequences may be harsher for females. The study tests the hypothesis that physical and sexual abuse will individually and cumulatively increase the risk for opioid misuse, and females will have a higher risk than males. METHODS A statewide sample of 79,960 justice-involved children in Florida were examined. Opioid misuse, illicit and non-medical use, was measured by urine analysis or self-disclosure within the past-30 days. Bivariate and multivariate logistic regression analyses were employed. Marginal effects were estimated to investigate the interaction between abuse and sex. RESULTS Over 2000 youth met the criteria for opioid misuse. One-third of female opioid users experienced both physical and sexual abuse. Compared to those with no history of physical or sexual abuse, those who were physically abused had 43% higher odds of opioid misuse, those who were sexually abuse had 78% higher odds, and those who experienced both had twice as high odds of opioid misuse. The individual and combined effects of these abuse types were higher for females. For example, female youth who were sexually abused had 2.7-times higher odds of opioid misuse than males who were sexually abused. CONCLUSION Intervention efforts can be improved by integrating physical and sexual abuse into risk assessments and tailoring assessments by sex.
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Affiliation(s)
- Micah E. Johnson
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | - Farwah Zaidi
- The Study of Teen Opioid Misuse and Prevention Laboratory, Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
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21
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Pike JR, Fadardi JS, Stacy AW, Xie B. The prospective association between illicit drug use and nonprescription opioid use among vulnerable adolescents. Prev Med 2021; 143:106383. [PMID: 33359759 PMCID: PMC7856303 DOI: 10.1016/j.ypmed.2020.106383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
In recent years, more than half of all drug overdose deaths in United States involved an opioid. To address this epidemic, antecedents to opioid misuse must be identified and empirically validated. The objective of the current investigation was to examine whether illicit drug use was prospectively associated with nonprescription opioid use among adolescents from a vulnerable population with a greater prevalence of substance abuse. A population-based cohort study of 1060 adolescents from 29 alternative high schools in southern California was conducted over a two-year period. A total of 929 adolescents (mean age 17.5 years, 49.9% female, 76.4% Hispanic) who had not experimented with nonprescription opioids at the baseline assessment were included in the analytic sample. The outcome was self-reported use of nonprescription opioids within two years. The predictors tested were illicit drug use, illicit drug use excluding marijuana, and the use of nonmedical marijuana. Covariates included age, sex, ethnicity, socioeconomic status, parental education, weekly income, sensation seeking, stress, anxiety, depression, and the use of alcohol and nicotine products. Multilevel, covariate-adjusted logistic regression models indicated that the odds of experimentation with nonprescription opioids was greater among adolescents who had used illicit drugs or illicit drugs excluding marijuana. Nonmedical marijuana use alone was a statistically significant predictor in unadjusted but not covariate-adjusted models. While prior studies have examined the progression from nicotine, alcohol, and marijuana use to nonprescription opioid use, the present findings emphasize the importance of illicit drug use as a detectable and empirically supported risk factor for future opioid misuse.
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Affiliation(s)
- James Russell Pike
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
| | - Javad Salehi Fadardi
- School of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran; School of Psychology, Bangor University, Bangor, United Kingdom; School of Community and Global Health, Claremont Graduate University, Claremont, CA, United States
| | - Alan W Stacy
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, United States
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, United States
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