Associations between childhood trauma and non-fatal overdose among people who inject drugs

Lake, Stephanie; Hayashi, Kanna; Milloy, M-J; Wood, Evan; Dong, Huiru; Montaner, Julio S. G.

doi:10.1016/j.addbeh.2014.12.014

Cited by 35 publications

(33 citation statements)

References 52 publications

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“…This was defined as responding "yes" to the question: "In the last six months, have you overdosed by accident (i.e., where you had a negative reaction from using too much drugs or had a bad trip)?" Our definition of non-fatal overdose using a self-reported measure is consistent with previous research, including those from the VIDUS/ACCESS cohort and others (Hunter et al, 2018;Lake et al, 2015).…”

Section: Study Variablessupporting

confidence: 52%

The relationship between parental heavy drinking and non-fatal overdose among people who inject drugs in Vancouver, Canada

Prangnell

Nosova

Milloy

et al. 2019

Addictive Behaviors

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Background: Despite the acute drug-related and behavioural risk factors for experiencing a drug overdose, few remote childhood experiences have been examined as risk factors for subsequent later life overdose risk. Parental heavy drinking has been associated with some later life negative outcomes, but little is known regarding the impact on drug overdoses, especially among people who inject drugs. Given the current overdose crisis in North America, we sought to evaluate the impact of parental heavy drinking on later life non-fatal overdose among people who inject drugs in Vancouver, Canada. Methods: Data were derived from two prospective cohort studies of community-recruited people who inject drugs in Vancouver between December 2012 and May 2016. We employed multivariable generalized estimating equations to examine the relationship between parental heavy drinking and non-fatal overdose in the past six months. Results: Among 327 eligible participants, 111 (33.9%) reported parental heavy drinking and 95 (29.1%) reported a non-fatal overdose at least once during the study period. In a multivariable analysis, experiencing parental heavy drinking remained independently associated with non-fatal overdose (adjusted odds ratio: 1.69; 95% confidence interval: 1.07-2.66) after adjustment for a range of socio-demographic and drug using confounders. Conclusions: These findings suggest long-term negative impacts of parental heavy drinking, on subsequent risk taking or other mechanisms associated with overdose. Current overdose

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Section: Study Variablessupporting

confidence: 52%

The relationship between parental heavy drinking and non-fatal overdose among people who inject drugs in Vancouver, Canada

Prangnell

Nosova

Milloy

et al. 2019

Addictive Behaviors

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“…, Lake et al . ), and in an effort to avoid issues of collinearity between the various measures of maltreatment. To fit each of the five multivariable confounding models, we employed a conservative variable selection approach (Maldonado & Greenland ).…”

Section: Methodsmentioning

confidence: 99%

“…Next, we fitted a separate multivariable confounding model for each type of the five forms of maltreatment. This approach was based on previous studies that employed a similar method using the CTQ (Stoltz et al 2007, Lake et al 2015, and in an effort to avoid issues of collinearity between the various measures of maltreatment. To fit each of the five multivariable confounding models, we employed a conservative variable selection approach (Maldonado & Greenland 1993).…”

Section: Methodsmentioning

confidence: 99%

High school incompletion and childhood maltreatment among street-involved young people in Vancouver, Canada

Barker

Dong

Wood

et al. 2015

Health Soc Care Community

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While the link between educational attainment and future health and wellness is well understood, little investigation has considered the potential impacts of distinct forms of childhood maltreatment on high school completion. In the present study, the relationship between five categories of childhood maltreatment (physical, emotional, and sexual abuse, and physical and emotional neglect) and completion of high school education were examined using the Childhood Trauma Questionnaire (CTQ). From September 2005 to May 2013, data were collected for the At-Risk Youth Study (ARYS), a cohort of street-involved young people who use illicit drugs in Vancouver, Canada. We used logistic regression to examine the relationship between childhood maltreatment and high school completion, while controlling for a range of potential confounding variables. Specifically, five separate models for each category of maltreatment and two combined models were employed to examine the relative associations between, and cumulative impact of, different forms of childhood maltreatment and educational attainment. Among 974 young people, 737 (76%) reported not completing high school. In separate multivariable analyses physical abuse, emotional abuse, physical neglect, and emotional neglect remained positively and independently associated with an incomplete high school education. In a combined multivariable model with all forms of childhood maltreatment considered together, emotional abuse (adjusted odds ratio = 2.08; 95% confidence interval: 1.51–2.86) was the only form of maltreatment that remained significantly associated with an incomplete high school education. The cumulative impact assessment indicated a moderate dose-dependent trend where the greater the number of different forms of childhood maltreatment the greater the risk of not completing a high school education. These findings point to the need for trauma-informed interventions to improve educational attainment among vulnerable young people, as well as evidence-based prevention programmes, such as the Nurse–Family Partnership, aimed at supporting at-risk families before maltreatment occurs.

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“…Drugs and alcohol can also be used as avoidant coping to escape the intrusive thoughts and feelings of PTSD (Brady & Back, 2012;Garland, Pettus-Davis, & Howard, 2013). Moreover, childhood trauma additionally worsens the progression and outcome of problematic drug use (Heffernan et al, 2000;Lake et al, 2015). In summary, there are multiple ways in which childhood trauma may affect substance use, and one would expect that the life stories of problem drug users would contain stories of severe and repeated childhood trauma.…”

Section: Introductionmentioning

confidence: 95%

Trauma in the childhood stories of people who have injected drugs

Hammersley

Dalgarno

McCollum³

et al. 2015

Addiction Research & Theory

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Aim: To document childhood trauma in the life stories of people who have injected drugs. Method: Fifty-five participants (38 m, 17 f) recruited via Scottish recovery networks, who had injected drugs in the previous five years, were interviewed by peer researchers using the Life Story method. Results: Remembered childhood trauma included persistent violence, repeated sexual abuse, neglect and traumatic bereavements. Many traumas were related to adult alcohol use. Few participants told of no trauma, some of severe trauma contributing to subsequent drug problems, some recounted stories including traumatic events, but not linked to later drug problems. A few told of initial severe behavioural problems leading to trauma for the child and to drug problems. Drug problems followed trauma by various routes, without straightforward cause and effect: direct use of drugs as avoidant coping; juvenile heavy recreational use that escalated; forming relationships in mid to late teens with criminals. For men, this involved enmeshment in drug dealing, crime and prison. Some women formed relationships with men who injected drugs, who often introduced them to drugs, and some of whom were violently abusive. Heroin injecting was an effective means of blotting out distressing thoughts and feelings. Although, childhood stories also contained positive memories, factors that might have promoted resilience were rarely mentioned. Conclusions: Severe childhood trauma was common and gravitated people towards problem drug use via various pathways. Participants had often normalised the problems and did not remember adult help. Parental alcohol use contributed to trauma. Addiction services need to be more trauma minded. ARTICLE HISTORY

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Associations between childhood trauma and non-fatal overdose among people who inject drugs

Cited by 35 publications

References 52 publications

The relationship between parental heavy drinking and non-fatal overdose among people who inject drugs in Vancouver, Canada

The relationship between parental heavy drinking and non-fatal overdose among people who inject drugs in Vancouver, Canada

High school incompletion and childhood maltreatment among street-involved young people in Vancouver, Canada

Trauma in the childhood stories of people who have injected drugs

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