The relationships of childhood trauma and adulthood prescription pain reliever misuse and injection drug use.
We examined associations between childhood trauma and adulthood prescription pain reliever misuse (PPRM) and injection drug use (IDU) in a nationally-representative U.S. sample to further understanding of factors associated with these epidemics.



National Longitudinal Study of Adolescent to Adult Health data (N=12,288) yielded nine childhood traumas: neglect; emotional, physical, sexual abuse; parental incarceration and binge drinking; witnessed, threatened with, and experienced violence. We estimated adjusted odds ratios (AOR) and 95% confidence intervals for the association of each trauma and cumulative trauma and drug initiation in emerging and later adulthood.



Outcome prevalences were 20% (PPRM) and 1% (IDU) in emerging adulthood and 10% PPRM in adulthood. We observed dose-response relationships that varied across outcomes. Cumulative trauma (referent=none) was associated with 34-79% greater odds of PPRM (emerging adulthood) across one to five+ trauma categories. The gradient was most consistent and associations strongest for adulthood PPRM: one trauma AOR=1.46(1.12, 1.91); two AOR=1.71(1.23, 2.36); three AOR=2.16(1.43, 2.36); four AOR=2.70(1.42, 5.62); five+ AOR=3.09(1.52, 6.30). Dose-response was less consistent for IDU, but 4 and 5+ traumas were associated with approximately seven and five times the odds of IDU. Neglect, emotional abuse, and parental incarceration and binge drinking were associated with 25-55% increased odds of PPRM. Sexual abuse and witnessed violence were associated with nearly 3 and 5 times the odds of IDU.



Associations between childhood trauma and PPRM/IDU highlight the need for trauma-informed interventions for drug users and early trauma screening and treatment for prevention of drug misuse over the life course.
Department of Population Health, NYU School of Medicine, 227 East 30th Street, New York, NY 10016, United States. Electronic address: Kelly.Quinn@nyumc.org.
Kelly
K
Quinn
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
Lauren
L
Boone
Department of Population Health, NYU School of Medicine, 227 East 30th Street, New York, NY 10016, United States.
Joy D
JD
Scheidell
National Development and Research Institutes, Inc., 71 West 23rd Street, New York, NY 10010, United States.
Pedro
P
Mateu-Gelabert
Department of Biostatistics, College of Public Health & Health Professions, College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL 32611, United States.
Susan P
SP
McGorray
National Development and Research Institutes, Inc., 71 West 23rd Street, New York, NY 10010, United States.
Nisha
N
Beharie
Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, United States.
Linda B
LB
Cottler
Department of Population Health, NYU School of Medicine, 227 East 30th Street, New York, NY 10016, United States.
Maria R
MR
Khan
D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000009:adverse effects*; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000639:trends; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D063487:Prescription Drug Misuse / Q000523:psychology* / Q000639:trends; D012742:Sex Offenses / Q000523:psychology / Q000639:trends; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D014754:Violence / Q000523:psychology* / Q000639:trends; D055815:Young Adult
D000700:Analgesics
Childhood trauma; Injection drug use; Prescription pain relievers; Trauma-informed interventions