Substance Misuse Being Traced Back To Adverse Childhood Experiences (ACEs)

Building resiliency in people who grew up in challenging environments is finding traction as a way to combat the drug overdose epidemic.

According to the Centers for Disease Control and Prevention, Adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood (0-17 years). For example:

  • experiencing violence or abuse
  • witnessing violence in the home or community
  • having a family member attempt or die by suicide

Also included are aspects of the child’s environment that can undermine their sense of safety, stability, and bonding such as growing up in a household with:

  • substance misuse
  • mental health problems
  • instability due to parental separation or household members being in jail or prison

ACEs are linked to chronic health problems, mental illness, and substance misuse in adulthood. ACEs can also negatively impact education and job opportunities. However, ACEs can be reversed. (CDC, Adverse Childhood Experiences direct text, 2020).


“We have the largest drug overdose epidemic in our lifetime and the greatest suicide epidemic in our lifetime,” says Keith Cartwright, Dept. of Behavioral Health and Developmental Services in the Virginia Department of Health.

ACEs is a relatively new field of study and research is indicating that the higher a person’s ACEs score, the more likely they are to experience a wide range of health issues, including substance misuse, he explains. Someone who has had at least one adverse childhood experience is three times more likely to have substance misuse issues.

“If you’re growing up in a hostile home, a violent home, a home that isn’t as friendly or nurturing as other homes, your brain will get wired to always anticipate that something hard is coming, and a sense of hopelessness is created. This has a lot of long-term impacts and unhealthy outcomes,” says Cartwright.

Addiction is one such outcome. Others can include obesity, cancer, asthma, heart disease, risk of mental health illness and even suicide.

“We are exploring ways to build resiliency in our young people, to halt that cycle before it can have a chance to have these long-term harmful effects,” he says. This is obviously a daunting task, as resiliency needs to be available across all areas of a young person’s life, including the classroom.

Trauma Informed Care is the umbrella phrase that is encompassing this effort to provide support that will allow a child to overcome or manage behavioral or mental health concerns resulting from ACEs. “Resiliency is not so much about this person getting tougher. It’s about us wrapping (needed services) around them, identifying root causes and providing support so they can work through these issues,” says Cartwright. “My hope around ACEs is that we start understanding that prevention starts way back when the child is young and sensitive to the stresses they face, when their brain is most active and developing … we can, through strong positive relationships, make them resilient. But it’s going to take a community effort.

For more information about ACEs and Trauma Informed Care, contact