ArticleDrug and alcohol dependence2019
Internalizing and externalizing factors on the pathway from adverse experiences in childhood to non-medical prescription opioid use in adulthood.
Article in Drug and alcohol dependence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04678960 (Preventing Opioid Use Among Justice-involved Youth as They Transition to Adulthood), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Preventing Opioid Use Among Justice-involved Youth as They Transition to Adulthood: Leveraging Safe Adults (LeSA)
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Opioid Misuse and Suicide-Related Outcomes Among Adolescents and Young Adults: A Systematic Review.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Pooled it
- Health harms of non-medical prescription opioid use: A systematic review.Drug and alcohol review · 2022Pooled it
- Preventing opioid use among justice-involved youth as they transition to adulthood: leveraging safe adults (LeSA).BMC public health · 2021Trial
- Illicit Prescription Opioid Use Among U.S. Firefighters.Fire (Basel, Switzerland) · 2025Article
- Article
- Adolescents' Adverse Childhood Experiences, Poor Mental Health, and Substance Use During the COVID-19 Pandemic.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025Article
- Nationally Representative Rates of Incident Prescription Opioid Use Among United States Adults and Selected Subpopulations: Longitudinal Cohort Study From the National Health Interview Survey, 2019 to 2020.The journal of pain · 2024Article
- Internalizing Pathways to Adolescent Substance Use from Adverse Childhood Experiences.International journal of environmental research and public health · 2024Article
- Giving Voice to Women with Substance Use Disorder: Findings from Expressive Writing About Trauma.Women's health reports (New Rochelle, N.Y.) · 2024Article
- A comprehensive evaluation of adverse childhood experiences, social-emotional impairments, and neurodevelopmental disorders in cannabis-use disorder: Implications for clinical practice.European psychiatry : the journal of the Association of European Psychiatrists · 2023Article
- Adverse childhood experiences and prescription opioid use during pregnancy: an analysis of the North and South Dakota PRAMS, 2019-2020.BMC pregnancy and childbirth · 2023Article
- Drug use patterns and factors related to the use and discontinuation of medications for opioid use disorder in the age of fentanyl: findings from a mixed-methods study of people who use drugs.Substance abuse treatment, prevention, and policy · 2023Article
- The effect of stress on opioid addiction-related behaviors: A review of preclinical literature.Experimental and clinical psychopharmacology · 2023Review
- Concurrent and proximal associations among PTSD symptoms, prescription opioid use, and co-use of other substances: Results from a daily monitoring study.Psychological trauma : theory, research, practice and policy · 2023Article
- Psychosocial Correlates of Opioid Use Profiles among Young Adults in a Longitudinal Study across 6 US Metropolitan Areas.Substance use & misuse · 2023Article
- Article
- Sex differences in the association of adverse childhood experiences on past 30-day opioid misuse among Florida justice-involved children.Journal of substance abuse treatment · 2022Article
- Adverse childhood experiences among females in substance use treatment and their children: A pilot study.Preventive medicine reports · 2021Article
- Early Life Stress and Risks for Opioid Misuse: Review of Data Supporting Neurobiological Underpinnings.Journal of personalized medicine · 2021Review
- Current Prescription Opioid Misuse and Suicide Risk Behaviors Among High School Students.Pediatrics · 2021Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundResearch 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.
methodsWe 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.
resultsAll 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)].
conclusionsInternalizing 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.
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Registered trials
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