Screening Adults With Substance Use Disorder for Adverse Childhood Experiences

Abstract

Objective: The purpose of this study was to assess the incidence of adverse childhood experiences (ACEs) and the efficacy and feasibility of a trauma-informed screening for ACEs among individuals in a substance use disorder recovery program. Method: Individual interviews, questionnaires, and postinterview survey and reflections were used in this cross-sectional clinical translation project. Descriptive statistics were used to analyze demographics, ACE scores, protective childhood experiences, self-reported diagnoses, and postintervention survey data. Postinterview reflections were reviewed and grouped into common ideas as shared by participants, as well as interesting impressions, insights, and responses to the interviews. Results: Thirty clients participated in the interview process. Among the 29 participants who completed the questionnaires, all reported at least one ACE, and 82.8% reported six or more ACEs. In addition, 96.6% reported experiencing more than four protective factors. Twelve (40%) clients were referred for further mental health counseling after the interviews. Notable findings from the interviews were the general lack of awareness of the relationship between ACEs and current substance use disorder among participants. Gaining knowledge about the impact of ACEs on their recovery seemed to provide a sense of relief and a feeling that they were “normal.” Conclusions: The trauma-informed care approach is intended to promote mindfulness regarding the effect of ACEs on substance abuse in this population. Screening for ACEs is necessary if effective interventions are to be provided, with the goal of improving client outcomes.

Nationwide efforts for trauma-informed care implementation and workforce development in healthcare and related fields: a systematic review

“…3,11,22,23,31,32 Mental health is associated with exposure to multiple ACEs, including learning and behavioral problems, somatic disorders, hallucinations, anxiety and obsessivecompulsive disorders, substance use disorders, depression and subsequent suicide attempts during adulthood as well as posttraumatic stress disorder, which may not always respond to traditional treatment. 2,5,[10][11][12][19][20][21]27,28,[33][34][35][36] Previous studies have explored how ACEs create an environment of traumatic toxic stress that can lead to prolonged activation of the stress response system, excess cortisol circulation, and disruption of the neuroendocrine and immune systems. When the stress response system remains on high alert, it can lead to remodeling of neurological pathways particularly in the hippocampus, amygdala, and prefrontal cortex.…”

Posljedice ranog traumatskog iskustva

“…(2014.) potvrdili su povezanost NDI s alkoholizmom, pušenjem, dijabetesom, koronarnim bolestima, depresijom, invaliditetom i psihičkim problemima odraslih 6 16 . Zaštitni čimbenici, kao npr.…”

Principles of Care for Young Adults With Co-Occurring Psychiatric and Substance Use Disorders

“…First, studies reveal patients are often unaware of the relationship between trauma exposure and current substance use. 82 Therefore, patients may not mention past trauma because they do not recognize its relevance. Survivors may also be reluctant to disclose trauma because of shame and guilt, fear of judgment, or concern about resulting family discord.…”