Different types of adverse childhood experiences (neglect, abuse, household dysfunction) were associated with different substance use patterns across racial and ethnic groups.
Prevention researchers, trauma-informed care providers, and multicultural counselors.
Different ACE domains predicted different substance use patterns across racial/ethnic groups
What the researchers found
Among 2,207 young adults, significant racial/ethnic differences existed in overall ACE scores and household dysfunction. Different ACE domains (neglect, abuse, household dysfunction) predicted different substance use patterns (nicotine, cannabis, opioids) depending on the racial/ethnic group, suggesting one-size-fits-all prevention approaches may miss important variations.
Why it matters
Understanding that childhood adversity affects substance use differently across racial groups can inform culturally tailored prevention programs rather than generic interventions.
The numbers in context
2,207 young adults, mean age 21.84. Significant racial/ethnic differences in overall ACE scores and household dysfunction. Different ACE domains predicted different substance use patterns by race/ethnicity.
How the study worked
Cross-sectional analysis of 2,207 young adults (mean age 21.84). Multivariable regression examining associations between three ACE domains and nicotine, cannabis, and opioid use/co-use across racial/ethnic groups.
What this study cannot tell us
Cross-sectional design. Self-reported ACEs and substance use. Combining diverse groups within broad racial/ethnic categories may obscure within-group variation. Cannot establish causation.
How to read the evidence
Reasonable sample with nuanced analysis of ACE domains by race/ethnicity, but cross-sectional design limits causal conclusions.
When this study was published
2025 publication.
The bigger picture
This study challenges the assumption that ACEs have uniform effects on substance use. The racial/ethnic variation in which ACE domains drive which substance use patterns reflects the intersection of trauma, culture, and structural inequality.
Questions still open
- What specific cultural or structural factors explain why different ACE domains affect substance use differently across groups?
- Would culturally tailored interventions addressing specific ACE domains be more effective than universal programs?
Read the original research
Diversity in adversity: Racial/ethnic differences in the relationship between domains of adverse childhood experiences and nicotine, cannabis, and opioids use in young adults.
Journal of ethnicity in substance abuse, 24(4), 829-849
Citation
Jacobs, Wura; Bristow, Alane; Sajan, Sandiya; Lowry, Veronica; Leventhal, Adam. (2025). Diversity in adversity: Racial/ethnic differences in the relationship between domains of adverse childhood experiences and nicotine, cannabis, and opioids use in young adults.. Journal of ethnicity in substance abuse, 24(4), 829-849. https://doi.org/10.1080/15332640.2023.2280092
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