TY - JOUR
T1 - Internalizing and externalizing factors on the pathway from adverse experiences in childhood to non-medical prescription opioid use in adulthood
AU - Quinn, Kelly
AU - Frueh, Bartley C.
AU - Scheidell, Joy
AU - Schatz, Daniel
AU - Scanlon, Faith
AU - Khan, Maria R.
N1 - Funding Information:
This work was supported by National Institute on Drug Abuse (NIDA) study R01DA036414 : Longitudinal Study of Trauma, HIV Risk , and Criminal Justice Involvement and T32 DA007233B : Behavioral Sciences Training in Drug Abuse Research Program, NYU Rory Meyers College of Nursing . These sponsors had no involvement in study design; in collection, analysis, or interpretation of data; in the writing of the report; and in the decision to submit the report for publication.
Funding Information:
This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development , with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website ( http://www.cpc.unc.edu/addhealth ). No direct support was received from grant P01-HD31921 for this analysis. We also acknowledge non-funding support from The Center for Drug Use and HIV/HCV Research (CDUHR) grant P30DA011041 .
Funding Information:
This work was supported by National Institute on Drug Abuse (NIDA) study R01DA036414: Longitudinal Study of Trauma, HIV Risk, and Criminal Justice Involvement and T32 DA007233B: Behavioral Sciences Training in Drug Abuse Research Program, NYU Rory Meyers College of Nursing. These sponsors had no involvement in study design; in collection, analysis, or interpretation of data; in the writing of the report; and in the decision to submit the report for publication.This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgment is due to Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis. We also acknowledge non-funding support from The Center for Drug Use and HIV/HCV Research (CDUHR) grant P30DA011041.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Background: Research demonstrates strong associations between adverse childhood experiences (ACEs) and non-medical prescription opioid use (NMPO), but pathways are not understood, hindering prevention and treatment responses. Methods: We assessed hypothesized mediators of the association between ACEs and NMPO in a nationally-representative U.S. sample. National Longitudinal Study of Adolescent to Adult Health data (N = 12,288) yielded an ordinal exposure comprising nine ACEs (neglect; emotional, physical, sexual abuse; parental incarceration and binge drinking; witnessed, threatened with, experienced violence) and a binary lifetime NMPO outcome. Nine potential mediators measured in adolescence and/or adulthood included depression, anxiety, suicidality, delinquency, impulsivity, and risk-taking. We estimated adjusted odds ratios (AOR) and 95% confidence intervals (CI) for sex-stratified associations of: ACEs and mediators; mediators and NMPO; and ACEs and NMPO adjusting for mediators individually and simultaneously. Results: All associations of ACEs and mediators were statistically significant and similar by sex. All mediators had statistically significant associations with NMPO (except one depression measurement for each sex). Delinquency was strongly associated with ACEs and NMPO and was the strongest individual mediator. Every ACE increase was associated with increased NMPO odds of 32% for males and 27% for females. Adjusting for all mediators, odds of NMPO were attenuated partially for males [AOR = 1.18 (95% CI:1.07, 1.31)] and somewhat more for females [AOR = 1.11 (95% CI:1.00, 1.25)]. Conclusions: Internalizing and externalizing factors partially explained the pathway from ACEs to NMPO. Substance abuse may be more difficult to treat with co-occurring psychopathologies and maladaptive behaviors, highlighting the need to address trauma early in life.
AB - Background: Research demonstrates strong associations between adverse childhood experiences (ACEs) and non-medical prescription opioid use (NMPO), but pathways are not understood, hindering prevention and treatment responses. Methods: We assessed hypothesized mediators of the association between ACEs and NMPO in a nationally-representative U.S. sample. National Longitudinal Study of Adolescent to Adult Health data (N = 12,288) yielded an ordinal exposure comprising nine ACEs (neglect; emotional, physical, sexual abuse; parental incarceration and binge drinking; witnessed, threatened with, experienced violence) and a binary lifetime NMPO outcome. Nine potential mediators measured in adolescence and/or adulthood included depression, anxiety, suicidality, delinquency, impulsivity, and risk-taking. We estimated adjusted odds ratios (AOR) and 95% confidence intervals (CI) for sex-stratified associations of: ACEs and mediators; mediators and NMPO; and ACEs and NMPO adjusting for mediators individually and simultaneously. Results: All associations of ACEs and mediators were statistically significant and similar by sex. All mediators had statistically significant associations with NMPO (except one depression measurement for each sex). Delinquency was strongly associated with ACEs and NMPO and was the strongest individual mediator. Every ACE increase was associated with increased NMPO odds of 32% for males and 27% for females. Adjusting for all mediators, odds of NMPO were attenuated partially for males [AOR = 1.18 (95% CI:1.07, 1.31)] and somewhat more for females [AOR = 1.11 (95% CI:1.00, 1.25)]. Conclusions: Internalizing and externalizing factors partially explained the pathway from ACEs to NMPO. Substance abuse may be more difficult to treat with co-occurring psychopathologies and maladaptive behaviors, highlighting the need to address trauma early in life.
KW - Adolescent health
KW - Adverse childhood experiences
KW - Delinquency
KW - Mental health
KW - Prescription opioid misuse
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U2 - 10.1016/j.drugalcdep.2018.12.029
DO - 10.1016/j.drugalcdep.2018.12.029
M3 - Article
C2 - 30849646
AN - SCOPUS:85062429283
VL - 197
SP - 212
EP - 219
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
SN - 0376-8716
ER -