Exploring the Nexus of Adverse Childhood Experiences and Illicit Substance Misuse among Midwestern Adults

The positive association between illicit substance misuse and adverse childhood experiences (ACEs) has been widely examined in prior literature. Yet, there is limited understanding of the varying factors, such as social support, depressive symptoms, or sexual victimization, that may impact the relationship between substance misuse and ACEs. As such, the purpose of the current study is to examine the relationship between ACEs (i.e., physical and emotional abuse, sexual abuse, neglect) with illicit substance misuse and to investigate indirect pathways of social support, depressive symptoms, and sexual victimization. Private, secondary data from the second cohort of a larger, longitudinal rural health cohort (RHC) study of Midwestern adults who use drugs (n = 650) was utilized. Results revealed that ACEs were common among this sample, with slightly more than 78% disclosing the experience of at least one type of physical and emotional abuse, nearly 75% reporting at least one type of neglect, and roughly 40% disclosing at least one type of sexual abuse before the age of 18. In terms of ACEs, results show those with more types of ACEs exposure experience greater depressive symptoms and more sexual victimization than those with fewer types of ACEs. Further, those with greater depressive symptoms and more sexual victimization utilize a greater number of different illicit substances. Although males have fewer sexual victimization experiences than females, they report using a greater number of illicit substances than females. Study results demonstrate the critical need for targeted interventions and support services for individuals with a history of childhood trauma who also present with illicit substance misuse. Continued research in this field may provide valuable insights for public health policies, address health inequalities, and aid in the development or tailoring of treatments. Advisor: Kimberly A. Tyler