Young adulthood is period of great change for individuals in which they are at a high risk of substance misuse. Around 60% of youth report alcohol use, 36% report cannabis use, and 24% report tobacco use by high school graduation. Multiple factors impact substance use behaviors including access, peer and family influences, and independence. Adverse childhood experiences (ACEs), such as child maltreatment, divorce, and familial substance use, impact mental, physical, and behavioral health. Additionally, ACEs can increase one’s risk of developing maladaptive coping behaviors such as substance misuse. This study examines the potential impact of childhood stressors on substance use in young adults ages 18-29.
This study is a meta-analysis that included results from 43 studies identified using PubMed and PsycINFO. Eligibility criteria for the studies included research on young adults (age 18-29), studies published between January 1, 1998- January 1, 2021, outcomes related to substance use or misuse, the primary predictor was more than one ACE, and studies were observational in nature. The outcomes of interest in this meta-analysis were use of alcohol, tobacco, cannabis, and other drugs. Common indicators of ACEs that were utilized were psychological, physical, and sexual abuse, substance misuse, mental illness, violence against mothers, and criminal behavior in the household. Data was analyzed using the matrix organization method to summarize the results of all 43 studies included within the meta-analysis.
Results of the data analysis showed that in the majority of studies that examined alcohol use, ACE exposure was positively associated with alcohol use. In addition, ACEs were associated with increased alcohol use, binge/problem drinking, and alcohol use disorders. Around half of the studies examined tobacco use and found that higher levels of ACEs were associated with cigarette use. Four of the studies looked at electronic cigarette use and three of them found an association between ACEs and electronic cigarette use. The studies that assessed cannabis use found that ACEs were positively associated with use, past year use, and daily use. Five of the studies examined gender differences and three of them found that the association between ACEs and electronic cigarette use, alcohol use consequences, and illicit drug use was stronger for males than for females. In the studies that assessed race/ethnicity it was found that ethnic minorities had stronger ACE and substance use relationships than non-Hispanic white participants.
Takeaway: Analysis of adverse childhood experiences may provide predictive value when assessing substance use in young adults.