Adverse Childhood Experiences and Opioid Use Disorder: A Systematic Review

Abstract

Over the past several decades, opioid use has consistently increased. Thought to be related to poor prescribing and drug availability, since the onset of the pandemic, there has been a dramatic shift in opioid overdoses. While pandemic stress may explain some of the rapid rise in drug misuse, research suggests other variables (i.e., trauma) may make individuals particularly vulnerable to opioid use and abuse. This systematic review sought to examine the relationship between adverse childhood experiences (ACEs) and opioid use disorder (OUD). Following guidelines established by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P), we conducted this systematic review using the Pubmed academic database. Searching research beginning in 2000-current, we found 48 articles that met our inclusion criteria. We used a team-based approach to conduct a thematic synthesis of the data. Four central analytical themes emerged including the nature of childhood relationship patterns, type of ACE, ACEs and OUD moderators, and biomarkers as predictors of OUDs. Several findings from this review may help to explain the relationship between ACEs and OUD. OUD is partially predicted by ACEs severity and frequency, type of ACE (i.e., abuse, neglect, parental substance use), psychiatric comorbidities, neurotransmitter level, and genetics. Resiliency may be key to OUD prevention. Both ACEs and OUD make lasting alterations in brain structure and biochemical pathways. Future research should focus on treatments to disrupt biochemical pathways that solidify craving. Clinicians may help by using risk-based assessments, promoting resiliency, and including families in treatment.