Social Vulnerability for Polysubstance Use: Exploring the Substance Use Initiation and Pattern among Children with Cumulative Trauma

Abstract

Background: Due to a concerning rise in reported cases of childhood abuse in India, this study was initiated with the aim of uncovering the social determinants contributing to childhood trauma. Moreover, the second objective of the study was to discuss substance use initiation and patterns among children with cumulative trauma. Method: As a result, an in-depth interview served as a primary source of viewpoints to examine the essential objective. The study was conducted on children with a history of abuse. Twenty-eight children in the age group of 13–18 years (Mage = 16) residing in child-care institutes in Assam were taken into consideration. Results: Content analysis indicated child care and education, parental divorce or remarriage, domestic violence, family mental illness, household substance misuse, parental health, parental crime, poverty, and sexual and physical violence as social determinants of health for childhood trauma. Children reported using alcohol, marijuana, tobacco, cough syrup, inhalants such as paint, and glue, chewables such as betel nut and Gutka (chewing tobacco), and pharmaceutical tablets. Initiation and pattern of substance use among early initiators were likely to be encouraged by detrimental peer influence, indicating substance abuse as normal behavior and the family’s role in shaping children’s pattern of substance use. Problematic patterns of substance use were identified, for instance, health consequences, neglect of responsibilities, and increased daily frequency. Conclusion: The results of this study may offer practical insights for healthcare professionals, enhancing their comprehension and addressing the social determinants of health indicating trauma and referring them to appropriate treatments. A holistic approach, which encompasses the collaboration of policymakers and healthcare providers, is vital for fostering health equity, thereby potentially preventing child abuse, childhood trauma and subsequent recidivism of substance use.