{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T22:34:42Z","timestamp":1792103682920,"version":"4.4.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Sociol."],"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> Although a substantial body of research documents a relationship between traumatic stress in childhood and the initiation of substance use later in the life course, only limited research has examined potential linkages between adverse childhood experiences (ACEs) and the initiation of non-medical prescription opioid use and other opioid use behaviors. The present study contributes to this growing body of work by investigating the association of childhood trauma with early initiation of a series of opioid use behaviors.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> New York City young adults (<jats:italic>n<\/jats:italic> = 539) ages 18\u201329 who reported non-medical use of prescription opioids or heroin use in the past 30 days were recruited using Respondent-Driven Sampling in 2014\u201316. Ten ACEs were assessed via self-report with the ACE Questionnaire. Associations between number of ACEs and self-reported ages of initiating seven opioid use behaviors (e.g., non-medical prescription opioid use, heroin use, heroin injection) were estimated with multivariable logistic regression.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Eighty nine percent of participants reported at least one ACE, and 46% reported four or more ACEs, a well-supported threshold indicating elevated risk for negative health consequences. Every increase of one trauma was associated with a 12\u201323% increase in odds of early initiation across the seven opioid use behaviors. Findings also document that the mean age at initiation increased with increasing risk severity across the behaviors, contributing to evidence of a trajectory from opioid pill misuse to opioid injection.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> Increasing number of childhood traumas was associated with increased odds of earlier initiation of multiple opioid misuse behaviors. In light of prior research linking earlier initiation of substance use with increased substance use severity, present findings suggest the importance of ACEs as individual-level determinants of increased opioid use severity. Efforts to prevent onset and escalation of opioid use among at-risk youth may benefit from trauma prevention programs and trauma-focused screening and treatment, as well as increased attention to ameliorating upstream socio-structural drivers of childhood trauma.<\/jats:p>","DOI":"10.3389\/fsoc.2021.620395","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T08:05:05Z","timestamp":1620893105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":29,"title":["Adverse Childhood Experiences Predict Early Initiation of Opioid Use Behaviors"],"prefix":"10.3389","volume":"6","author":[{"given":"Honoria","family":"Guarino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Mateu-Gelabert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Quinn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skultip","family":"Sirikantraporn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly V.","family":"Ruggles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Syckes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Goodbody","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Jessell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1016\/j.drugalcdep.2015.12.026","article-title":"Predictors of transition to heroin use among initially non-opioid dependent illicit pharmaceutical opioid users: a natural history study","volume":"160","author":"Carlson","year":"2016","journal-title":"Drug Alcohol Depend"},{"key":"B2","unstructured":"Atlanta, GAU.S. Department of Health and Human Services, Centers for Disease Control and PreventionBehavioral Risk Factor Surveillance System ACE Module Data, 20102015"},{"key":"B3","unstructured":"Atlanta, GAU.S. Department of Health and Human Services, Centers for Disease Control and PreventionThe ACE Study Survey Data [Unpublished Data].2016"},{"key":"B4","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1016\/j.jpeds.2015.04.071","article-title":"Nonmedical prescription opioid use in childhood and early adolescence predicts transitions to heroin use in young adulthood: a national study","volume":"167","author":"Cerda","year":"2015","journal-title":"J. Pediatrics"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jadohealth.2005.06.006","article-title":"Adverse childhood experiences and the association with ever using alcohol and initiating alcohol use during adolescence","volume":"38","author":"Dube","year":"2006","journal-title":"J. Adolesc. Health"},{"key":"B6","unstructured":"The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders, and sexual behavior: implications for healthcare,\n            FelittiV. J.\n            AndaR.\n          \n            LaniusR.\n            VermettenE.\n            PainC.\n          The Hidden Epidemic: The Impact of Early Life Trauma on Health and Disease2009"},{"key":"B7","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/S0749-3797(98)00017-8","article-title":"Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults","volume":"14","author":"Felitti","year":"1998","journal-title":"Am. J. Prevent. Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1198\/jasa.2011.ap09475","article-title":"Improved inference for Respondent-Driven Sampling data with application to HIV prevalence estimation","volume":"106","author":"Gile","year":"2011","journal-title":"J. Am. Stat. Assoc"},{"key":"B9","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.drugalcdep.2011.04.004","article-title":"30-year trajectories of heroin and other drug use among men and women sampled from methadone treatment in California","volume":"118","author":"Grella","year":"2011","journal-title":"Drug Alcohol Depend."},{"key":"B10","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.addbeh.2018.04.017","article-title":"Young adults' opioid use trajectories: from nonmedical prescription opioid use to heroin, drug injection, drug treatment and overdose","volume":"86","author":"Guarino","year":"2018","journal-title":"Addict. Behav"},{"key":"B11","doi-asserted-by":"publisher","first-page":"135","DOI":"10.3109\/16066359.2015.1093120","article-title":"Trauma in childhood stories of people who have injected drugs","volume":"24","author":"Hammersley","year":"2016","journal-title":"Addict. Res. Theory"},{"key":"B12","unstructured":"HandcockM. S.\n            FellowsI. E.\n            GileK. J.\n          RDS: Respondent-Driven Sampling, version 0.72012"},{"key":"B13","doi-asserted-by":"publisher","first-page":"174","DOI":"10.2307\/3096941","article-title":"Respondent-Driven Sampling: a new approach to the study of hidden populations","volume":"44","author":"Heckathorn","year":"1997","journal-title":"Social Prob"},{"key":"B14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1023\/A:1014528612685","article-title":"Extensions of Respondent-Driven Sampling: a new approach to the study of injection drug users aged 18-25","volume":"6","author":"Heckathorn","year":"2002","journal-title":"AIDS Behav"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e1002922","DOI":"10.1371\/journal.pmed.1002922","article-title":"Prescription opioid use and misuse among adolescents and young adults in the United States: a national survey study","volume":"16","author":"Hudgins","year":"2019","journal-title":"PLoS Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.drugalcdep.2013.01.007","article-title":"Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers\u2014United States, 2002-2004 and 2008-2010","volume":"132","author":"Jones","year":"2013","journal-title":"Drug Alcohol Depend."},{"key":"B17","doi-asserted-by":"publisher","first-page":"38","DOI":"10.15585\/mmwr.su6901a5","article-title":"Prescription opioid misuse and use of alcohol and other substances among high school students \u2013 Youth Risk Behavior Survey, United States, 2019","volume":"69","author":"Jones","year":"2020","journal-title":"MMWR"},{"key":"B18","doi-asserted-by":"publisher","first-page":"231","DOI":"10.3109\/10673229709030550","article-title":"The self-medication hypothesis of substance use disorders: a reconsideration and recent applications","volume":"4","author":"Khantzian","year":"1997","journal-title":"Harvard Rev. Psychiatry"},{"key":"B19","volume-title":"Understanding Addiction as Self-Medication: Finding Hope Behind the Pain","author":"Khantzian","year":"2008"},{"key":"B20","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1146\/annurev-publhealth-031914-122957","article-title":"The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction","volume":"36","author":"Kolodny","year":"2015","journal-title":"Ann. Rev. Public Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1007\/s11524-012-9691-9","article-title":"Patterns of prescription drug misuse among young injection drug users","volume":"89","author":"Lankenau","year":"2012","journal-title":"J. Urban Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1111\/j.1521-0391.2013.00319.x","article-title":"A comparison of trauma profiles among individuals with prescription opioid, nicotine or cocaine dependence","volume":"22","author":"Lawson","year":"2013","journal-title":"Am. J. Addict"},{"key":"B23","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1001\/jamapsychiatry.2017.0113","article-title":"Changes in US lifetime heroin use and heroin use disorder: prevalence from the 2001-2002 to 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions","volume":"74","author":"Martins","year":"2017","journal-title":"JAMA Psychiatry"},{"key":"B24","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1186\/s12954-020-00367-2","article-title":"Prescription opioid injection among young people who inject drugs in New York City: a mixed-methods description and associations with hepatitis C infection and overdose","volume":"17","author":"Mateu-Gelabert","year":"2020","journal-title":"Harm Reduct. J"},{"key":"B25","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.drugpo.2017.05.016","article-title":"High enhancer, downer, withdrawal helper: multifunctional nonmedical benzodiazepine use among young adult opioid users in New York City","volume":"46","author":"Mateu-Gelabert","year":"2017","journal-title":"Int. J. Drug Policy"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1920","DOI":"10.1111\/j.1360-0443.2007.02015.x","article-title":"Does early onset of non-medical use of prescription drugs predict subsequent prescription drug abuse and dependence? Results from a national study","volume":"102","author":"McCabe","year":"2007","journal-title":"Addiction"},{"key":"B27","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1007\/s10935-020-00578-0","article-title":"Adverse childhood experiences increase risk for prescription opioid misuse","volume":"41","author":"Merrick","year":"2020","journal-title":"J. Primary Prevent"},{"key":"B28","volume-title":"CBHSQ Data Review: Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States","author":"Muhuri","year":"2013"},{"key":"B29","doi-asserted-by":"publisher","first-page":"703","DOI":"10.2105\/AJPH.2003.019372","article-title":"Childhood sexual abuse and age at initiation of injection drug use","volume":"95","author":"Ompad","year":"2005","journal-title":"Am. J. Public Health"},{"key":"B30","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1016\/j.drugalcdep.2016.09.021","article-title":"The relationships of childhood trauma and adulthood prescription pain reliever misuse and injection drug use","volume":"169","author":"Quinn","year":"2016","journal-title":"Drug Alcohol Depend"},{"key":"B31","unstructured":"Vienna, AustriaR: a language and environment for statistical computing2015"},{"key":"B32","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1037\/a0013628","article-title":"Opioids and the treatment of chronic pain: controversies, current status, and future directions","volume":"16","author":"Rosenblum","year":"2008","journal-title":"Exp. Clin. Psychopharmacol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1111\/j.0081-1750.2004.00152.x","article-title":"Sampling and estimation in hidden populations using Respondent-Driven Sampling","volume":"34","author":"Salganik","year":"2004","journal-title":"Sociol. Methodol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1080\/10550880802545101","article-title":"The prevalence of childhood trauma among those seeking buprenorphine treatment","volume":"28","author":"Sansone","year":"2009","journal-title":"J. Addict. Dis"},{"key":"B35","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/j.drugalcdep.2017.07.007","article-title":"Adverse childhood experience effects on opioid use initiation, injection drug use, and overdose among persons with opioid use disorder","volume":"179","author":"Stein","year":"2017","journal-title":"Drug Alcohol Depend"},{"key":"B36","unstructured":"Rockville, MDCenter for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services AdministrationKey substance use and mental health indicators in the United States: results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07- 01-001, NSDUH Series H-55)2020"},{"key":"B37","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.drugalcdep.2017.06.034","article-title":"Heroin use onset among nonmedical prescription opioid users in the club scene","volume":"179","author":"Surratt","year":"2017","journal-title":"Drug Alcohol Depend"},{"key":"B38","unstructured":"Washington DCGovernment Printing OfficeUnderstanding the Effects of Maltreatment on Early Brain Development.2001"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v045.i03","article-title":"MICE: multivariate imputation by chained equations in R","volume":"45","author":"Van Buuren","year":"2011","journal-title":"J. Stat. Softw"},{"key":"B40","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.drugalcdep.2017.10.013","article-title":"Nonmedical prescription opioids and pathways of drug involvement in the US: generational differences","volume":"182","author":"Wall","year":"2018","journal-title":"Drug Alcohol Depend"},{"key":"B41","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/S0749-3797(98)00011-7","article-title":"What explains the negative consequences of adverse childhood experiences on adult health? Insights from cognitive and neuroscience research","volume":"14","author":"Weiss","year":"1998","journal-title":"Am. J. Prev. Med"},{"key":"B42","unstructured":"Geneva, SwitzerlandIntroduction to HIV\/AIDS and sexually transmitted infection surveillance: Module 4: Introduction to Respondent-Driven Sampling2013"}],"container-title":["Frontiers in Sociology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsoc.2021.620395\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T08:05:12Z","timestamp":1620893112000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsoc.2021.620395\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,13]]},"references-count":42,"alternative-id":["10.3389\/fsoc.2021.620395"],"URL":"https:\/\/doi.org\/10.3389\/fsoc.2021.620395","relation":{},"ISSN":["2297-7775"],"issn-type":[{"value":"2297-7775","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,13]]},"article-number":"620395"}}