Objective

Adverse childhood experiences (ACEs) such as emotional, physical, or sexual abuse, parental separation or imprisonment, and household substance use disorder have been reported in about 16% of Americans. The number of ACEs has also been positively correlated to opioid use disorder (OUD) later in life. The aim of this study was to consider a scientific basis for a preventive strategy for OUD.

Methods

This was a narrative review of the literature through PubMed, Cochrane, Embase, and Web of Science databases.  The search was for peer-reviewed literature related to “adverse childhood experiences”, “substance use”, “opioid use disorder”, and “opioids.” Bibliographic references in key articles were also used to supplement information.

Results

An increased number of ACEs is associated with a greater probability of OUD, overdose, injection opioid abuse, and starting opioids at a younger age. Adverse events in childhood are thought to trigger bodily stress responses that negatively affect emotional development and change brain function. ACEs can adversely affect mood and self-regulation. Greater awareness of the long-term consequences of ACEs is needed among those outside the medical and psychological communities to help shape preventive interventions that may reduce OUD.

Conclusion

Although clear-cut efforts as how to reduce ACEs remain undefined, reducing ACEs would likely reduce OUD. Greater awareness of ACEs by health care professionals, the public, educators, and political decision-makers is urgently needed.