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. 2016 Aug;55(8):701-8.
doi: 10.1016/j.jaac.2016.05.010. Epub 2016 May 27.

Childhood Trauma and Illicit Drug Use in Adolescence: A Population-Based National Comorbidity Survey Replication-Adolescent Supplement Study

Hannah Carliner  1 , Katherine M Keyes  2 , Katie A McLaughlin  3 , Jacquelyn L Meyers  4 , Erin C Dunn  5 , Silvia S Martins  2
Affiliations

Childhood Trauma and Illicit Drug Use in Adolescence: A Population-Based National Comorbidity Survey Replication-Adolescent Supplement Study

Hannah Carliner et al. J Am Acad Child Adolesc Psychiatry. 2016 Aug.

Abstract

Objective: Although potentially traumatic events (PTEs) are established risk factors for substance use disorders among adults, little is known about associations with drug use during adolescence, an important developmental stage for drug use prevention. We examined whether childhood PTEs were associated with illicit drug use among a representative sample of US adolescents.

Method: Data were drawn from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A), which included adolescents aged 13 to 18 years (N = 9,956). Weighted logistic regression models estimated risk ratios for lifetime use of marijuana, cocaine, nonmedical prescription drugs, other drugs, and multiple drugs.

Results: Exposure to any PTE before age 11 years was reported by 36% of the sample and was associated with higher risk for use of marijuana (risk ratio [RR] = 1.50), cocaine (RR = 2.78), prescription drugs (RR = 1.80), other drugs (RR = 1.90), and multiple drugs (RR = 1.74). A positive monotonic relationship was observed between number of PTEs and marijuana, other drug, and multiple drug use. Interpersonal violence was associated with all drug use outcomes. Accidents and unspecified events were associated with higher risk for marijuana, cocaine, and prescription drug use.

Conclusion: Potentially traumatic events in childhood are associated with risk for illicit drug use among US adolescents. These findings add to the literature by illustrating a potentially modifiable health behavior that may be a target for intervention. The results also highlight that adolescents with a trauma history are a high-risk group for illicit drug use and may benefit from trauma-focused prevention efforts that specifically address traumatic memories and coping strategies for dealing with stressful life events.

Keywords: adolescents; childhood trauma; illicit drugs; maltreatment; substance use.

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Figures

Figure 1
Figure 1
Adjusted risk ratios and 95% CIs for lifetime illicit drug use associated with number of potentially traumatic experiences before age 11 among adolescents in the National Comorbidity Survey–Adolescent Supplement (N=9,956). Note: For each model, the reference group is adolescents exposed to no potentially traumatic events (PTEs) prior to age 11. All models adjusted for age, sex, race/ethnicity, parent income, and parent substance use problems.
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