Substance Abuse And Addiction As A Result Of Adverse Childhood Experiences (ACEs)

Adverse Childhood Experiences (ACEs) are a risk factor for health, social, and behavioral problems, including substance abuse and addiction. Persons who experience an adverse childhood experience are more vulnerable to these dangers from childhood into adulthood. Many of the risks which are linked to ACES are in themselves risk factors for addiction.

Identifying ACEs as soon as possible helps prevent future harm and substance abuse as a person ages. Recognizing ACEs as risk factors for substance abuse can help to prevent drug and alcohol abuse. It can also help treatment providers tailor treatments for individuals who already struggle with a substance use disorder.

About Adverse Childhood Experiences (ACEs)

From 1995 to 1997 more than 17,000 Kaiser Permanente Health Maintenance Organization members took part in a study that examined the connection between childhood abuse and neglect and later-life health and well-being.

This study, the CDC-Kaiser Permanente Adverse Childhood Experiences Study (also referred to as the Kaiser ACE Study), was one of the largest of its kind. To this day, the study’s findings set the groundwork for future scientific research, preventative measures, and treatment initiatives for ACEs.

This study determined how Adverse Childhood Experiences can alter a person’s development and put them at risk for harm later in life. Specifically, it found that ACEs can disrupt a child’s neurodevelopment, or the way critical functions within the brain develop and work.

From this, a person can suffer social, emotional, and cognitive impairment. These changes can then cause a person to adopt high-risk behaviors which put them at risk of disease, disability, and social problems, including substance abuse. The combination of these effects can then cause a person to have a higher risk of early death.

When determining a person’s risk for developing these problems and health conditions, health and medical professionals look at a person’s childhood to determine their ACE score. As a person’s ACE score rises, their risk for serious health problems climbs and the potential for harm to their life increases. One of the gravest ways this is experienced is through substance abuse.

Connection Between Adverse Childhood Experiences And Substance Abuse

The greater a person’s ACE score, the greater their risk for alcohol abuse, alcoholism, and drug abuse. The Substance Abuse and Mental Health Services Administration (SAMHSA) cautions that “Each ACE increased the likelihood of early initiation into illicit drug use by 2- to 4-fold.”

Adverse Childhood Experiences can be deeply traumatic. Traumatic events experienced as a child increase a person’s risk for substance abuse. Additionally, having a parent who drinks or abuses drugs (an ACE) is a risk factor for a child developing an addiction later in life.

Further, a person who has experienced an ACE also has a higher risk of developing mental health problems, such as depression. Mental illnesses are a significant risk factor for addiction and quite commonly occur alongside substance abuse (a co-occurring disorder). According to SAMHSA, in 2014, 7.9 million adults struggled with a co-occurring disorder.

Research shows that Adverse Childhood Experiences are linked to:

  • higher rates of lifetime illicit drug abuse
  • an increased risk for mental and substance use disorders in individuals aged 50 and older
  • underage drinking
  • problem drinking that continues from adolescence to adulthood
  • higher rates of prescription drug use, a potential risk factor for prescription drug abuse

In addition to an increased risk for substance use disorders, many of the other dangers linked to ACEs are risk factors for substance abuse.

Additional Dangers Of Adverse Childhood Experiences

According to the Centers for Disease Control and Prevention (CDC), research has found that individuals who have six or more ACEs, on average, have a life expectancy 20 years shorter than those who do not. Based on the Kaiser ACE Study, they reported the individuals with zero ACEs had an average life expectancy of 80 years, while those with six or more had a life expectancy of 60 years.

Further, the higher a person’s ACE score, the greater their risk of the following:

  • academic problems
  • depression
  • financial troubles
  • high-risk sexual behaviors
  • job struggles
  • risk for intimate partner violence
  • risk for sexual violence
  • serious health and medical problems
  • smoking
  • sleep disturbances
  • suicide attempts
  • unintended and adolescent pregnancies

Mental health problems like depression frequently lead a person to self-medicate with alcohol or drugs. Academic, financial, and relationship problems, and traumatic situations such as violence, are also problems which frequently lead a person to substance abuse. Because of this, and in order to break this potentially vicious cycle, support programs and treatment that are sensitive to the needs of a person with ACEs is crucial.

Substance Abuse And Addiction As A Result Of Adverse Childhood Experiences (ACEs) Types

Determining An ACE Score: Types Of Adverse Childhood Experiences

There are three categories of ACEs and 10 types of adverse experiences. A child may experience abuse, neglect, or household dysfunction, each of which comes in different forms, and all of which can be risk factors for substance abuse. A person’s ACE score is determined by the number of adverse experiences they have out of the 10 possible.

Neglect is the most common type of child maltreatment and abuse. While neglect is a form of child abuse, for the study and for ACE scoring it is listed as a separate category from abuse.

When a child is neglected they do not have their basic emotional or physical needs met. This means they may not receive care which provides the necessary clothing, food, healthcare, or shelter. Emotional neglect causes emotional pain and distress and occurs when a parent or caregiver doesn’t acknowledge, care for, or respond to a child’s feelings in a healthy way.

Household dysfunction includes situations in which a child witnesses or experiences distressing circumstances within the home. Examples include a parent who drinks or uses alcohol or violence against a child’s mother.

Percentage of respondents in the Kaiser ACE Study who experienced Adverse Childhood Experiences:


  • physical: 28 percent
  • sexual: 21 percent
  • emotional: 11 percent


  • emotional: 15 percent
  • physical: 10 percent

Household dysfunction:

  • substance abuse: 27 percent
  • divorce or separation: 23 percent
  • mental illness: 19 percent
  • mother treated violently: 13 percent
  • incarcerated member of the household: 5 percent

Adverse childhood experiences tend to appear in groups, and because of this, treatment practitioners should seek to understand the way they’re connected in order to understand how they impact the person as a whole.

A person may have ACE risk factors or a high ACE score and not experience negative effects within their adult life. However, people with ACE risk factors, especially those with high scores, do have a higher risk for experiencing harm to their physical, mental, and social health, especially substance abuse and addiction.

How Common Are ACEs?

Nearly two-thirds of the adults surveyed for the Kaiser ACE Study reported at least one Adverse Childhood Experience, according to the CDC. The majority had more than one, with over one in five reporting three or more ACEs. Specifically:

  • 36 percent had zero
  • 26 percent had one
  • 16 percent had two
  • 9.5 percent had three
  • 12.5 percent had four or more

More recent findings show that these trends continue to be problematic. Based on data from the 2016 National Survey of Children’s Health, a research group reported that:

  • 45 percent of U.S. children have experienced one or more ACEs
  • one in 10 U.S. children are considered high-risk, experiencing three or more ACEs

Researchers also found that certain races and ethnicities experience ACEs at higher rates, with white-non-Hispanic children and 23 percent of Asian non-Hispanic children seeing the lowest instances of ACEs.

Children who experienced one or more ACEs on a national level include:

  • 61 percent of black non-Hispanic children
  • 51 percent of Hispanic children
  • 40 percent of white non-Hispanic children
  • 23 percent of Asian non-Hispanic children

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Preventative And Protective Measures Against ACEs

Providing preventative and protective measures against ACEs for children and their families is one of the best steps towards reducing the negative impact of these influences as the child ages. Potentially, this includes reducing the risk for adolescent and adult substance abuse and addiction. For individuals who are currently struggling with a substance use disorder, this includes access to comprehensive, individualized treatment programs.

For children and adolescents at risk of substance abuse from ACEs, this includes helping a family to create safe, stable, and nurturing relationships and environments (SSNREs). At any age, it’s important that a person is taught coping skills so they can handle the stress caused by the ACEs.

Persons with ACEs who are working to achieve sobriety have an increased chance of building a healthy, drug-free life with professional help. Inpatient drug rehab programs give a person a greater opportunity for healing and personal development. Individuals who have experienced a mental health disorder as a result of ACEs may find the greatest benefit in a dual-diagnosis treatment program.

It’s important to remember that people with high ACE scores can still do well and find success, both in life and in recovery. Despite having experienced adverse childhood events, with the proper support these individuals can find balance and better health in their lives.

For more information be sure to check out these additional resources from


Child Trends — The prevalence of adverse childhood experiences, nationally, by state, and by race or ethnicity
Substance Abuse and Mental Health Services Administration — Adverse Childhood Experiences, Co-Occurring Disorders