The link between adverse childhood experiences and alcohol use was significantly stronger in adolescents who had attempted suicide, but ACEs and suicide attempt independently predicted cannabis use.
School-based mental health professionals, adolescent substance prevention specialists, and suicide prevention researchers.
AOR 2.63 for drinkingamong teens with both ACEs and suicide attempt, vs. 1.56 for ACEs alone, showing amplification
What the researchers found
ACEs by suicide attempt interaction was significant for drinking (attempt AOR=2.63 vs. no ideation AOR=1.56), but not for cannabis. ACEs (AOR=1.95-2.08) and suicide attempt (AOR=2.11) independently predicted greater cannabis use.
Why it matters
Identifying that trauma and suicidality interact to amplify drinking specifically can help target dual-risk adolescents for more intensive alcohol prevention while addressing cannabis use through separate pathways.
The numbers in context
1,625 high schoolers (50.8% male, 47.1% female, 2% nonbinary). ACEs x suicide attempt interaction significant for drinking. ACEs AOR for cannabis: 1.95-2.08. Suicide attempt AOR for cannabis: 2.11.
How the study worked
Ordinal logistic regression of Youth Risk Behavior Survey data from western New York, testing interactions between ACEs count and suicidality categories on substance use.
Who was studied
1,625 high school students in western New York.
What this study cannot tell us
Cross-sectional school-based survey. Self-reported ACEs and substance use. Single geographic region. Cannot determine temporal sequence between variables.
How to read the evidence
Cross-sectional survey with interaction analysis; hypothesis-generating but cannot establish causal pathways.
When this study was published
Recent YRBS data from western New York.
The bigger picture
This study reveals that trauma-exposed adolescents who attempt suicide face compounded risk specifically for alcohol use, while cannabis use appears driven by these risk factors independently, suggesting different intervention approaches are needed.
Replication
Single-region school survey; broader replication needed.
Funding
Not specified in abstract
Conflicts of interest
Not specified in abstract
Questions still open
- Why does suicidality amplify the ACE-alcohol link but not the ACE-cannabis link?
- Would trauma-informed interventions reduce substance use in suicidal adolescents?
Read the original research
Interactive effect of adverse child experiences and suicidal thoughts and behaviors on adolescent alcohol and cannabis use frequency.
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 37(8), 1019-1029
Citation
Kelly, Lourah; Meeker, Elizabeth; Zajac, Kristyn; Bryan, Rebecca; O'Connor, Briannon. (2023). Interactive effect of adverse child experiences and suicidal thoughts and behaviors on adolescent alcohol and cannabis use frequency.. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 37(8), 1019-1029. https://doi.org/10.1037/adb0000947