#​34 ACES: Risk factors

Recent research on substance abuse shows that many factors are involved in who becomes addicted to substances and who doesn’t.  More and more studies indicate that childhood trauma influences many long-term health outcomes. 
The Adverse Childhood Experiences (ACEs) assessment is one example of this research (also known as Kaiser Permanente CDC Study).  In the late nineties, 17,000 middle class Americans were given health assessments and a ten-question survey looking at childhood abuse (physical, emotional or sexual), household dysfunction (having a parent incarcerated, with a mental illness, involved in substance abuse, mother treated violently, parents separated or divorced), and physical or emotional neglect.  (The entire questionnaire can be easily found online by searching for “ACE Questionnaire.”)
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The reason adverse childhood experiences are so impactful is that young children quickly learn whether or not the world is safe by how their needs are met.  Babies and young children learn this through the care or neglect of a caregiver. Unmet needs increase the production of cortisol, causing the stress response system in the brain to be on constant high alert, diverting energy away from other parts of the brain.  This toxic stress weakens the parts of the brain that develop healthy emotional self-regulation, social interactions, and abstract thinking.  These stressors early in life affect not only emotional health and educational achievement, but long-term health and wellbeing as well.
 
As a person’s ACE score increases, so does the risk for negative outcomes. In their continuing studies, the CDC found that almost a quarter of those surveyed had three or more ACEs.  There is a dramatic link between having three or more ACEs and engaging in risky behaviors (accidents, injury, being a victim or perpetrator of violence), having psychological issues (mental illness, suicide, depression), serious chronic health conditions (including obesity, diabetes, heart disease, cancer, COPD), and lower educational attainment.  The Substance Abuse and Mental Health Services Administration (SAMHSA) cautions that “Each ACE increases the likelihood of early initiation into illicit drug use by 2- to 4-fold.”   People with six or more ACEs are likely to die twenty years earlier than those without ACEs.  Studies also show that children of parents affected by high ACE scores are likely to experience them as well, affecting future generations.
 
CDC research indicates that the economic toll of individuals having five or more ACEs costs the United States four hundred billion dollars each year in health care, special education, criminal justice and child welfare services. 
 
In addition to drastically increasing the likelihood of substance misuse, adverse childhood experiences have negative long-term effects on individuals and our society at large.  Next time we will discuss what can be done.