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Childhood trauma as a correlate of lifetime opiate use in psychiatric patients

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Abstract

Associations have been reported between childhood sexual and/or physical abuse and adult substance abuse in general. This study investigated the relationship between childhood abuse and opiate use in particular among 763 consecutively admitted psychiatric inpatients. Patients were interviewed about demographic information, alcohol and drug use, and history of interpersonal violence. Opiate users were 2.7 times more likely to have a history of childhood sexual and/or physical abuse than nonopiate users, after controlling for diagnostic and sociodemographic variables. Opiate use was higher among those reporting physical abuse alone (24.1%) or both physical and sexual abuse (27%) than among those reporting sexual abuse alone (8.8%). Implications of these findings are discussed.
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... Differences in gender-related response to ACEs were also investigated by some, either as the primary focus of their research (Lei et al., 2018;Winstanley et al., 2020) or as a component of a broader study (Conroy et al., 2009). Studies focusing on a specific range or concentration of ACEs include Heffernan et al. (2000), whose study focused on the links between physical and sexual violence in childhood and heavy opioid use; additionally, studies by Austin and Short (2020) and Beckman et al. (2022) examined the relationship between increased prescription use and misuse and OUD. ...
... This systematic review included studies across different settings and locations. Of the 20 studies included in this review, half (n = 9) were among clients from opioid use treatment clinics (Carr et al., 2021;Conroy et al., 2009;Derefinko et al., 2019;Gannon et al., 2017;Heffernan et al., 2000;O'Gurek et al., 2021;Sansone et al., 2009;Stein et al., 2017;Winstanley et al., 2020); five studies were conducted among the general population (Evans et al., 2020;Merrick et al., 2020;Tang et al., 2020;Z.Wang et al., 2021;Williams et al., 2020); three studies comprised respondents from student populations (Lei et al., 2018;Onu et al., 2020;Swedo et al., 2020); one study was conducted among biological mothers of neonates diagnosed with neonatal opioid withdrawal syndrome (Beltran-Arzate et al., 2021); and one study was conducted among people involved in the criminal justice system (Eaves et al., 2021). The nine treatment centers in the selected studies also represented different settings: five studies were from urban clinics (Carr et al., 2021;Conroy et al., 2009;Gannon et al., 2017;Heffernan et al., 2000;Stein et al., 2017); two studies were from rural clinics (Derefinko et al., 2019;Winstanley et al., 2020); one study was conducted among homeless people receiving care from a mobile treatment facility (O'Gurek et al., 2021); and one study did not specify the treatment setting (Sansone et al., 2009). ...
... Of the 20 studies included in this review, half (n = 9) were among clients from opioid use treatment clinics (Carr et al., 2021;Conroy et al., 2009;Derefinko et al., 2019;Gannon et al., 2017;Heffernan et al., 2000;O'Gurek et al., 2021;Sansone et al., 2009;Stein et al., 2017;Winstanley et al., 2020); five studies were conducted among the general population (Evans et al., 2020;Merrick et al., 2020;Tang et al., 2020;Z.Wang et al., 2021;Williams et al., 2020); three studies comprised respondents from student populations (Lei et al., 2018;Onu et al., 2020;Swedo et al., 2020); one study was conducted among biological mothers of neonates diagnosed with neonatal opioid withdrawal syndrome (Beltran-Arzate et al., 2021); and one study was conducted among people involved in the criminal justice system (Eaves et al., 2021). The nine treatment centers in the selected studies also represented different settings: five studies were from urban clinics (Carr et al., 2021;Conroy et al., 2009;Gannon et al., 2017;Heffernan et al., 2000;Stein et al., 2017); two studies were from rural clinics (Derefinko et al., 2019;Winstanley et al., 2020); one study was conducted among homeless people receiving care from a mobile treatment facility (O'Gurek et al., 2021); and one study did not specify the treatment setting (Sansone et al., 2009). One article was a case-control study (Conroy et al., 2009), whereas all other articles (n = 19) were cross-sectional studies, including one mixed method study (Beltran-Arzate et al., 2021). ...
Article
As opioid use-related behaviors continue at epidemic proportions, identifying the root causes of these behaviors is critical. Adverse childhood experiences (ACEs) are shown to be an important predictor of opioid initiation, opioid dependence, and lifetime opioid overdose. The purpose of this systematic review is to examine the association between ACEs and opioid use-related behaviors later in life and to discuss implications for policy, practice, and research regarding ACEs and opioids. Five databases (PubMed, PsycINFO, CINAHL, Medline, and Scopus) were used to identify studies investigating the association between ACEs and opioid use-related behaviors. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 20 studies out of the initial 428 met the inclusion criteria for this review. Among the included 20 studies, 15 focused on the relationship between ACEs and lifetime opioid use-related behaviors, and five focused on current opioid use-related behaviors. All studies found statistical associations between ACEs and lifetime or current opioid use-related behaviors. Five studies found a significant gradient effect; that is, as the number of ACEs increased, the risk of opioid use-related behaviors also increased. A significant dose–response relationship exists between ACEs and opioid use-related behaviors. Hence, it is essential for clinicians to screen for ACEs before prescribing opioid medications, for opioid treatment to incorporate trauma-informed methods, and for messaging around opioid use interventions to include information about ACEs. The current review points to a critical need to implement standardized ACE screening instruments in clinical and research settings.
... Çocukluk çağı travmalarının, özellikle istismar ve ihmalin, bireylerin yetişkinlik döneminde riskli alkol ve madde kullanımı ile ilişkilendirildiği birçok araştırmada ortaya konmuştur (21,22). Örneğin, Heffernan ve diğerleri (22) opiyat kullanıcılarında çocukluk çağı istismar öyküsünün varlığının, bu bireylerde opiyat kullanma olasılığını artırdığını belirtmişlerdir. ...
... Çocukluk çağı travmalarının, özellikle istismar ve ihmalin, bireylerin yetişkinlik döneminde riskli alkol ve madde kullanımı ile ilişkilendirildiği birçok araştırmada ortaya konmuştur (21,22). Örneğin, Heffernan ve diğerleri (22) opiyat kullanıcılarında çocukluk çağı istismar öyküsünün varlığının, bu bireylerde opiyat kullanma olasılığını artırdığını belirtmişlerdir. Ayrıca, çocukluk çağı travmaları ile duygu düzenleme arasında da önemli bir ilişki olduğu vurgulanmıştır (23,24). ...
Article
Amaç: Bu çalışma, çocukluk çağı travmalarının riskli alkol ve madde kullanımı ile cinsel kompulsiyonlar üzerindeki etkisinde bilişsel duygu düzenleme stratejilerinin aracı rolünü incelemeyi amaçlamaktadır. Yöntem: Araştırma, Ankara'daki üniversitelerde öğrenim gören 303 katılımcı ile yapılmıştır. Katılımcılara Çocukluk Çağı Travmaları Ölçeği, Cinsel Kompulsiyon Ölçeği, Bağımlılık Profil İndeksi Risk Tarama Ölçeği ve Bilişsel Duygu Düzenleme Ölçeği uygulanmıştır. Araştırmada kullanılan istatistiksel analiz yöntemleri arasında korelasyon, basit doğrusal regresyon ve aracı rol analizi için Model 4 yer almaktadır. Bulgular: Çocukluk çağı travmalarının riskli alkol ve madde kullanımını, cinsel kompulsiyonları ve bilişsel duygu düzenleme stratejilerini ve adaptif olmayan bilişsel duygu düzenleme stratejilerinin ise cinsel kompulsiyonları yordadığı bulunmuştur. Çalışmanın bulgularına göre, çocukluk çağı travmaları ile cinsel kompulsiyonlar arasındaki ilişkiyi adaptif olmayan bilişsel duygu düzenleme stratejileri aracılığıyla yordadığı tespit edilmiştir Sonuç: Çocukluk çağı travmalarının ve bilişsel duygu düzenleme stratejilerinin bağımlılık riski oluşturma süreçlerinde önemli birer etmen olduğunu vurgulamaktadır. Bu bulgular, bağımlılık alanındaki araştırmalar için önemli bir katkı sağlarken, uygulayıcılar için de iyileşme süreçlerinde dikkate alınması gereken kritik faktörleri ortaya koymaktadır.
... Those with adverse childhood experiences (ACEs) are at highest risk of opioid use disorder (82), and MAT non-compliance (83). Early interpersonal traumatic events, like physical and sexual abuse, are strongly associated with numbing, sedating drugs (84)(85)(86)(87), and alcohol (19,88,89). The SUDs of people with childhood trauma who develop subsequent mental health disorders may be especially unyielding to treatment as it exists today generally (90). ...
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The field of addiction in its priority to save lives has emphasized harm reduction and medication therapies that have taken precedence over counseling and psychotherapy. The extensive mental health needs, traumatic histories and cognitive challenges of this population call for more availability of all treatments, but also in-depth treatment for the causes of the addiction. The prevalence of trauma is examined with regard to the challenge it presents in treatment for substance use disorder (SUD), and other comorbidities. Two case examples are offered that exemplify how art therapy expedites key information about underlying trauma. Art therapy is proposed as a treatment approach for SUD for its apparent activation of key neural networks that are also impacted by trauma, and its usefulness in engaging those who have cognitive challenges experientially. Quantitative research is cited that suggests art therapy’s activation of the reward system, which may make art therapy useful in treating the stress and inhibition coefficients of addiction that map to neural networks of addiction. The need for additional empirical research is cited that may improve the efficiency and effectiveness of art therapy and mental health treatment.
... Egy korai amerikai tanulmányban (Heffernan et al, 2000) a szerzők 763 pszichiátriai pácienssel végeztek vizsgálatot, melyben a gyermekkori traumák és az ópiát használat életprevalenciájának kapcsolatát vizsgálták. Eredményeik alapján az ópiát használók 2,7-szer nagyobb eséllyel mutattak fel gyermekkori szexuális és/vagy fizikai bántalmazást, mint a nem ópiát használók. ...
... Low Agreeableness is specific only to SUDs and no other psychiatric conditions [40]. Reduced motivation and capacity to sustain positive relationships with others could result from high levels of childhood trauma [50] and the comorbidity of ADHD [51] found in patients with SUDs. A Norwegian opioid-dependence population showed low scores for Extraversion [52]. ...
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The development of a substance use disorder (SUD) is a multifaceted process influenced by both genetic and environmental factors. Recent research has suggested the potential involvement of the HINT1 gene in various aspects of plasticity, mood regulation, anxiety-like behaviour, and stress-coping mechanisms. Moreover, personality traits are also recognised to be instrumental in developing substance dependency. Given these considerations, our study investigated the associations among cigarette smoking, personality traits, and the rs2526303 polymorphism. Additionally, we investigated the interactions between personality traits and rs2526303 in the HINT1 gene. The study group comprised 531 volunteers: 375 cigarette users (mean age = 29.42 ± 10.72; F = 49%, M = 51%) and 156 never-smokers (mean age = 26.93 ± 10.09; F = 79%, M = 21%). Genotyping was conducted using the real-time PCR method, and the NEO Five-Factor Personality Inventory and State–Trait Anxiety Inventory were administered. There were no statistically significant differences in the frequency of rs2526303 genotypes and alleles in the cigarette user group compared to the control group. Compared to the control group, the cigarette users obtained higher scores in the assessment of the NEO-FFI Extraversion scale and lower results for the NEO-FFI Openness, Agreeableness, and Conscientiousness scales. Additionally, there was a statistically significant effect of rs2526303 genotype interaction and cigarette-using status on the conscientiousness scale. These outcomes collectively suggest a notable association between cigarette smoking and specific dimensions of personality, particularly highlighting differences in extraversion, openness, agreeableness, and conscientiousness. Furthermore, the detected interaction effect involving rs2526303 concerning conscientiousness signifies a complex interplay between genetic factors and smoking behaviour.
... This behavior can result in less condom insistence and a greater likelihood of unprotected sex [13]. Substantial evidence shows that women who experienced lifetime abuse are twice as likely to suffer from AUD when compared to women who experienced either childhood abuse or intimate partner violence alone [14][15][16]. These women are more likely to begin drinking at a younger age and report more problems related to alcohol use [17][18][19]. ...
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general background: the interrelated systems of the brain / the psychobiological symptomology of PTSD [physiological arousal, loss of emotions as signals] / psychophysiological effects of trauma [conditioned responses to specific stimuli, hyperarousal to intense but neutral stimuli] / neurohormonal effects of trauma [background: neurohormones and their roles in the stress response, specific neuroendocrine abnormalities in PTSD] / developmental level affects the psychobiological effects of trauma [trauma, neurohormones, and memory consolidation] / trauma and the central nervous system [background: structures and functions of the limbic system, "emotional memory may be forever," specific limbic system abnormalities in PTSD, lateralization] (PsycINFO Database Record (c) 2012 APA, all rights reserved)