A childhood marred by abuse, neglect, and other traumatic experiences may contribute to opioid misuse among young adults according to a study published in the Journal of American College Health.

A study from the 1990s showed adverse childhood experiences contributed to illicit drug and alcohol use. A more recent study showed adults between age 18 and 25 had the highest rate of opioid misuse compared with teens and adults aged 26 and older. The researchers in the current study wanted to explore the connection between “early life risk exposures” and opioid use among university students.

The researchers collected data from students at a large public university in Georgia through an online survey in late 2019. Out of the 1,740 students who completed the survey, 1,402 were included in the study. Most were white (76.5%) women (74.8%).

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In addition to demographic and health information, the survey included validated questions on adverse childhood experiences, risk of opioid misuse, pain, opioid knowledge, and “household factors.”

The researchers found that of the students at risk for opioid misuse, 89.4% reported at least1 past or current health condition. About 61% reported at least 1 adverse childhood experience. Most adverse childhood experiences were significantly associated (P < .05) with risk of opioid use.

Participants who reported 4 or more adverse childhood experiences were nearly 3 (95% CI: 1.95, 4.39; P < .001) times more likely to be at a risk for opioid misuse than those who experienced no adverse events. Participants with 1 to 3 adverse childhood experiences were almost twice (95% CI: 1.46, 2.65; P < .001) as likely to be at risk of opioid misuse.

There were some limitations to the study. The convenience sample format of the study may not be generalizable to the public at large, the researchers state. The cross-sectional design and the instrument used also serve as limitations to the data’s accuracy.

“Despite the limitations, the study provides the field with an additional set of data to support the notion that early life adversity is an important but highly ignored factor that increases the likelihood of opioid misuse,” the researchers conclude. “Future studies will benefit from replications with random samples of young adults and include measures on pain history, perceptions, and beliefs about taking opioids and pain medication and the decision-making process of taking opioids.”


Fortson K, Rajbhandari-Thapa J, Ingels J, Thapa K, Dube SR. Adverse childhood experiences, risk of opioid misuse and its pathway among students at a public university. J Am Coll Health. Published online November 17, 2021. doi:10.1080/07448481.2021.2002336