Childhood Trauma and Prescription Drug Misuse in a College Population

Abstract Introduction: Adverse childhood experiences (ACE) predict health-compromising behaviors such as substance use. However, few studies have examined the association between ACE and prescription drug misuse among young adults—a growing public health concern. College students are especially vulnerable to prescription drug misuse due to social and academic stressors. This study investigated associations between ACE and prescription drug misuse (e.g., antidepressants, opiates, sedatives and stimulants) among a diverse college population, as well as gender and racial/ethnic variations in these associations. Methods: Data are from the 2018 American College Health Association’s National College Health Assessment II (N = 3899) at a large, diverse university in California. Logistic regression models assessed the association between ACE and prescription drug misuse adjusting for gender and race/ethnicity and explored gender and racial/ethnic differences in the ACE/prescription drug misuse association. Results: ACE was associated with misuse of all prescription drugs. Due to significant effect modification by ethnicity in the relationship between ACE and stimulant misuse (p < 0.05), models were stratified by race/ethnicity. Every additional ACE was associated with an increase in adjusted odds of stimulant use among students identifying as Asian/Pacific Islander (API) and Hispanic, but not Whites. Conclusions: This study contributes to the mounting evidence regarding the importance of ACE screening and the use of campus-based prevention programs. This study also suggests programs should be tailored to address cultural variation.

[1]  L. Albers,et al.  Adverse Childhood Experiences and Health Indicators in a Young Adult, College Student Sample: Differences by Gender , 2020, International Journal of Behavioral Medicine.

[2]  M. Eisenberg,et al.  Adverse Childhood Experiences, Ethnicity, and Substance Use among College Students: Findings from a Two-State Sample , 2019, Substance use & misuse.

[3]  John J. Prindle,et al.  Extending poly-victimization theory: Differential effects of adolescents' experiences of victimization on substance use disorder diagnoses upon treatment entry. , 2019, Child abuse & neglect.

[4]  Bethany J Figg,et al.  Substance Abuse and Mental Health Services Administration , 2018, Journal of Consumer Health on the Internet.

[5]  I. Borowsky,et al.  Associations between adverse childhood experiences, student-teacher relationships, and non-medical use of prescription medications among adolescents. , 2017, Addictive behaviors.

[6]  Shannon M. Monnat,et al.  Long-Term Physical Health Consequences of Adverse Childhood Experiences , 2015, The Sociological quarterly.

[7]  M. Skeer,et al.  A systematic review of risk and protective factors associated with nonmedical use of prescription drugs among youth in the United States: a social ecological perspective. , 2015, Journal of studies on alcohol and drugs.

[8]  R. Hallock,et al.  A survey of nonmedical use of tranquilizers, stimulants, and pain relievers among college students: patterns of use among users and factors related to abstinence in non-users. , 2014, Drug and alcohol dependence.

[9]  Melissa T. Merrick,et al.  Examination of the Factorial Structure of Adverse Childhood Experiences and Recommendations for Three Subscale Scores. , 2014, Psychology of violence.

[10]  James R Carpenter,et al.  Multiple imputation of covariates by fully conditional specification: Accommodating the substantive model , 2012, Statistical methods in medical research.

[11]  W. Rothstein,et al.  Medical and Nonmedical Users of Prescription Drugs Among College Students , 2011, Journal of American college health : J of ACH.

[12]  J. Elhai,et al.  Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. , 2010, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[13]  Li Hui Chen,et al.  Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006. , 2009, NCHS data brief.

[14]  M. Twohig,et al.  Help-Seeking Experiences and Attitudes among African American, Asian American, and European American College Students , 2009 .

[15]  S. McCabe,et al.  Race/Ethnicity and Gender Differences in Drug Use and Abuse Among College Students , 2007, Journal of ethnicity in substance abuse.

[16]  S. Dube,et al.  Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence. , 2006, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[17]  C. Jack,et al.  Alzheimer's Disease Neuroimaging Initiative , 2008 .

[18]  D. Williamson,et al.  Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. , 2004, Child abuse & neglect.

[19]  I. Meyer Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. , 2003, Psychological bulletin.

[20]  R. Turner,et al.  Cumulative adversity and drug dependence in young adults: racial/ethnic contrasts. , 2003, Addiction.

[21]  D. Williamson,et al.  Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. , 1998, American journal of preventive medicine.

[22]  I. Meyer Minority stress and mental health in gay men. , 1995, Journal of health and social behavior.

[23]  Dale Nordenberg,et al.  Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study. , 2019, American journal of preventive medicine.

[24]  S. Benjamin,et al.  The relationship between family-based adverse childhood experiences and substance use behaviors among a diverse sample of college students. , 2018, Addictive behaviors.

[25]  D. Finkelhor,et al.  Poly-victimization: a neglected component in child victimization. , 2007, Child abuse & neglect.