Many of us were taught from a young age to keep our family’s dysfunctions a secret. If for nothing else, just to save face with our neighbors and friends. But it turns out that most of us were exposed to some sort of toxic stress or traumatic event in the household as children.

A recent study by the Health Policy Institute of Ohio (HPIO) found that nearly two-thirds of Ohioans have been exposed to adverse childhood experiences (ACEs), which are potentially traumatic events that occur during childhood. Ohioans with low incomes, residents of urban and Appalachian counties, and racial/ethnic minorities are more likely to experience multiple ACEs.

So, what are ACEs and how are they related to substance use? The Centers for Disease Control (CDC) says that ACEs can generally be grouped into three categories: abuse, household challenges and neglect[1]. Examples of these experiences may include emotional, physical and sexual abuse, and emotional or physical neglect. Growing up with family members who have a substance use disorder or mental illness, as well as parental divorce, domestic violence and incarceration are considered household challenges.

[1] About the CDC-Kaiser ACE Study. Centers for Disease Control

ACEs scores are calculated with a point applied for each traumatic experience someone endures during their childhood. ACEs scores may range anywhere from zero to ten. The higher an ACE score, the higher one’s risk of chronic health problems, mental illness and ultimately early death[1]. The three most commonly reported types of ACEs by Ohioans are emotional abuse (57%) followed by substance use by a household member (41%) and divorce (36%)[2].

ACEs are strongly related to a wide range of health problems throughout one’s life, including substance abuse. According to a white paper by the Substance Use and Mental Health Services Administration (SAMHSA), when children are exposed to stressful events, their brain development can be disrupted and their ability to cope with negative emotions can be impaired.

Over time, and especially during adolescence, children may resort to unhealthy coping mechanisms like substance use or self-harm. Unhealthy coping mechanisms and high-risk behaviors can have long-lasting impacts on one’s physical and emotional health.

Consider these findings:

• Each ACE increased the likelihood of early illicit drug use by twofold to fourfold.
• Childhood abuse and parental substance abuse put older adults (50+ years old) at a higher risk of developing a substance use disorder or mental illness later in life.
• The rate of prescription drug use increased by 62% for every additional ACE score.

Although the outlook for children who experience significant trauma may seem bleak, many children who are exposed to ACEs live long, healthy lives. Adverse childhood experiences are in fact very common, as most Ohioans report an ACE score of at least one. Protective factors such as a safe environment, positive adult relationships and social and emotional support, can help curb the negative effects of ACEs.

If you experienced adverse childhood experiences and are living with a substance use disorder or mental illness, resources are available to help you. If you live in Franklin County, you can access a full list of affordable, quality mental health and substance use disorder services through the Alcohol, Drug and Mental Health Board of Franklin County. If you live in other areas of the state, you can access services through the Ohio Department of Mental Health and Addiction Services.

And if you know of a child who is facing abuse or neglect, agencies across Ohio are available to assist. Child abuse and neglect can be reported through the Ohio Department of Job and Family Services at 855-O-H-CHILD (855-642-4453). Reports can be anonymous. For more information on ACEs, visit healthpolicyohio.org.

[1] About the CDC-Kaiser ACE Study.

[2] Reem, A., Reat, Z., et. al. Health impact of ACEs in Ohio. Health Policy Institute of Ohio. 28 August 2020.