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Associations Between Adverse Childhood Experiences and Tobacco, Alcohol, and Drug Use Among Individuals with Serious Mental Illnesses in Public-Sector Treatment Settings

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Abstract

Adverse childhood experiences (ACEs) increase risk of substance use disorders (SUDs). Little research has focused on individuals with serious mental illnesses (SMI), despite their high prevalence of both ACEs and SUDs. We combined two datasets from prior studies (n = 299 and n = 240, total n = 539) that measured ACEs and made research diagnoses for SUDs. When controlling for other variables—age, gender, race, diagnostic category (psychotic disorder versus mood disorder), and study site (Washington, DC-area versus southeast Georgia)— in logistic regression models, ACE score was associated with tobacco use, presence of any SUD, alcohol use disorder, cannabis use disorder, and cocaine use disorder. Each one-unit increase in the ACE score increased the odds of SUD-related outcomes by 9–18%. Clinicians, program planners, and researchers should be aware of the powerful and long-lasting impact of ACEs, and the need for thorough screening and assessment of both SUDs and ACEs among patients with SMI.

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Acknowledgements

Research reported in this publication was supported by a grant from the Office of the Vice President for Research of The George Washington University (“GW-Based Collaborative Research on Food Insecurity in Serious Mental Illnesses”), as well as National Institute of Mental Health grant R01 MH101307 (“A Trial of “Opening Doors to Recovery” for Persons with Serious Mental Illnesses”) to the last author. The content is solely the responsibility of the authors and does not necessarily represent the official views of The George Washington University, the National Institutes of Health, or National Institute of Mental Health.

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Authors and Affiliations

  1. New York State Psychiatric Institute, 722 W. 168th Street, Room R249, 10032, New York, NY, USA

    Michael T. Compton

  2. Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA

    Michael T. Compton & Adria Zern

  3. DeKalb Community Service Board, Decatur, GA, USA

    Stephanie Langlois & Oluwatoyin Ashekun

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  1. Michael T. Compton
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Compton, M.T., Zern, A., Langlois, S. et al. Associations Between Adverse Childhood Experiences and Tobacco, Alcohol, and Drug Use Among Individuals with Serious Mental Illnesses in Public-Sector Treatment Settings. Community Ment Health J 59, 363–369 (2023). https://doi.org/10.1007/s10597-022-01014-9

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