{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:43:44Z","timestamp":1788824624949,"version":"build-2803163510"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T00:00:00Z","timestamp":1680652800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Adverse childhood experiences (ACEs) are associated with an increased risk of poly-substance use among drug-using adults. However, there is a paucity of literature on a direct or indirect relationship between ACEs and drug use patterns. We thus aimed to identify the pathway of effects of ACEs on drug use patterns in adults by the structural equation model (SEM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional study was conducted by respondent-driving sampling and consecutive sampling among adult drug users in Southwest China in 2021. Descriptive, univariate, and SEM analyses were performed by R software 4.2.1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 406 participants recruited from a drug abuse clinic, the average age was 34 years. The majority of the participants were male patients (98.3%) from ethnic minorities (79.6%), who were unmarried (71.6%) and employed (81.2%). Nearly 95.5% experienced ACEs with 46.6% of them reporting four or more ACEs. The median value of self-perception of drug abuse score, friend drug use score, and drug use score was 8.0 (3.0, 11.0), 1.0 (0.0, 1.0), and 1.0 (1.0, 2.0) respectively. In the confirmatory analysis part of SEM, the construct of latent variables fitted well with the data. Poly-drug use was significantly and directly affected by three predictors including monthly incomes (\u03b2 = 0.09), friend drug use (\u03b2 = 0.50), and ACEs (\u03b2 = 0.11). The indirect effect of ACEs passing through self-perception of drugs (\u03b2 = 0.09) was not significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>ACEs have an independent and direct effect on the drug user for poly-drug use apart from the effect of drug-using friends and family income.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1043222","type":"journal-article","created":{"date-parts":[[2023,4,5]],"date-time":"2023-04-05T09:18:41Z","timestamp":1680686321000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Pathway of effects of adverse childhood experiences on the poly-drug use pattern among adults using drugs: A structural equation modeling"],"prefix":"10.3389","volume":"11","author":[{"given":"Jing","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhui","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiashuang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjia","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virasakdi","family":"Chongsuvivatwong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"139","DOI":"10.4045\/tidsskr.19.0251","article-title":"Polydrug use - prevalence and registration","author":"Walderhaug","year":"2019","journal-title":"Tidsskr Nor Laegeforen"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2454","DOI":"10.1111\/add.15422","article-title":"New psychoactives within polydrug use trajectories-evidence from a mixed-method longitudinal study","volume":"116","author":"Higgins","year":"2021","journal-title":"Addiction."},{"key":"B3","doi-asserted-by":"publisher","first-page":"106713","DOI":"10.1016\/j.aap.2022.106713","article-title":"Impacts of alcohol and opioid polysubstance use on road safety: systematic review","volume":"173","author":"Beaulieu","year":"2022","journal-title":"Accid Anal Prev."},{"key":"B4","unstructured":"2021"},{"key":"B5","unstructured":""},{"key":"B6","unstructured":""},{"key":"B7","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1080\/13651501.2017.1383439","article-title":"Clinical characteristics of poly-drug abuse among heroin dependents and association with other psychopathology in compulsory isolation treatment settings in China","volume":"22","author":"Yang","year":"2018","journal-title":"Int J Psychiatry Clin Pract."},{"key":"B8","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.addbeh.2016.11.017","article-title":"Polydrug use among urban adolescent cigarette smokers","volume":"66","author":"McKelvey","year":"2017","journal-title":"Addict Behav."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2085","DOI":"10.1111\/jgs.16032","article-title":"Associations of adverse childhood experiences with past-year DSM-5 psychiatric and substance use disorders in older adults","volume":"67","author":"Rhee","year":"2019","journal-title":"J Am Geriatr Soc."},{"key":"B10","doi-asserted-by":"publisher","first-page":"106489","DOI":"10.1016\/j.addbeh.2020.106489","article-title":"Depression and its association with adverse childhood experiences in people with substance use disorders and comorbid medical illness recruited during medical hospitalization","volume":"110","author":"Philogene-Khalid","year":"2020","journal-title":"Addict Behav."},{"key":"B11","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1016\/j.jad.2021.05.105","article-title":"Analysis of features of social anxiety and exploring the relationship between childhood major adverse experiences and social anxiety in early adulthood among Chinese college students","volume":"292","author":"Meng","year":"2021","journal-title":"J Affect Disord."},{"key":"B12","doi-asserted-by":"publisher","first-page":"170","DOI":"10.15288\/jsad.2014.75.170","article-title":"Polydrug use typologies and childhood maltreatment in a nationally representative survey of Danish young adults","volume":"75","author":"Armour","year":"2014","journal-title":"J Stud Alcohol Drugs."},{"key":"B13","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/j.ijchp.2018.07.003","article-title":"Torre-Luque Ad, Fern\u00e1ndez-Artamendi S. 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