Adolescent Opioid Misuse Attributable to Adverse Childhood Experiences - 19/08/20
, Steven A. Sumner, MD 2, Sietske de Fijter, MS 3, Luke Werhan, MPA 3, Kirkland Norris, MPH 4, Jennifer L. Beauregard, PhD 1, 5, 6, Martha P. Montgomery, MD 1, 3, 7, Erica B. Rose, PhD 1, 8, 9, Susan D. Hillis, PhD 2, 10, Greta M. Massetti, PhD 2Abstract |
Objectives |
To estimate the proportion of opioid misuse attributable to adverse childhood experiences (ACEs) among adolescents.
Study design |
A cross-sectional survey was administered to 10 546 seventh-to twelfth-grade students in northeastern Ohio in Spring 2018. Study measures included self-reported lifetime exposure to 10 ACEs and past 30-day use of nonmedical prescription opioid or heroin. Using generalized estimating equations, we evaluated associations between recent opioid misuse, individual ACEs, and cumulative number of ACEs. We calculated population attributable fractions to determine the proportion of adolescents' recent opioid misuse attributable to ACEs.
Results |
Nearly 1 in 50 adolescents reported opioid misuse within 30 days (1.9%); approximately 60% of youth experienced ≥1 ACE; 10.2% experienced ≥5 ACEs. Cumulative ACE exposure demonstrated a significant graded relationship with opioid misuse. Compared with youth with zero ACEs, youth with 1 ACE (aOR 1.9, 95% CI, 0.9-3.9), 2 ACEs (aOR, 3.8; 95% CI, 1.9-7.9), 3 ACEs (aOR, 3.7; 95% CI, 2.2-6.5), 4 ACEs (aOR, 5.8; 95% CI, 3.1-11.2), and ≥5 ACEs (aOR, 15.3; 95% CI, 8.8-26.6) had higher odds of recent opioid misuse. The population attributable fraction of recent opioid misuse associated with experiencing ≥1 ACE was 71.6% (95% CI, 59.8-83.5).
Conclusions |
There was a significant graded relationship between number of ACEs and recent opioid misuse among adolescents. More than 70% of recent adolescent opioid misuse in our study population was attributable to ACEs. Efforts to decrease opioid misuse could include programmatic, policy, and clinical practice interventions to prevent and mitigate the negative effects of ACEs.
Le texte complet de cet article est disponible en PDF.Abbreviations : ACE, CDC, PAF
Plan
| The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The authors declare no conflicts of interest. |
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| Portions of this study were presented at the Epidemic Intelligence Service (EIS) Conference, April 29-May 2, 2019, Atlanta, GA. |
Vol 224
P. 102 - septembre 2020 Retour au numéro
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