High ACE Scores and Mediating Risk in the Context of the Overdose Crisis

• In Event: Adverse Childhood Experiences, Psychopathy, and Outcomes in Adulthood

Abstract

The overdose crisis continues to plague the US, costing an estimated $1.5 Trillion in 2020. Persons engaged in the justice system have higher rates of substance use disorder relative to those without arrest histories and face multiple health risks that compound their risk of overdose. Post-incarceration risk of lethal overdose is alarmingly high among people who use drugs. Yet, our community-based approaches to overdose prevention have not received enough attention and more evidence-based approaches are needed. Utilizing a unique sample of 401 adults in SUD treatment in the Midwest (health-insurance=uninsured; Medicaid), we conduct hazard ratios for several high-risk outcomes surrounding drug use and criminality. Specifically, we consider an in-depth life-course history surveys to identify mediators that act as protective factors among people in treatment for SUD. Among those who experienced high childhood adversity (ACEs) and reported genetic SUD predisposition, factors were evaluated as protective against adverse adult experiences such as gun violence, suicidality, overdose, opioid use, intravenous drug use, sexual assault, and felony incarceration. We test for instance, whether having a mother who did not engage in problematic drug or alcohol behaviors mediated adverse adult outcomes and if so, could present an early-avenue for community-based overdose and crime prevention efforts.

Author

• Meghan O’Neil, Michigan State University