Deol Ekamjit, Siddiqui Zohair, Paracha Awais, Mujovic Haris, Abro Zohaib, Chang Steven R, Abid Ali, Tyler Jefferson H, Rehman Humza, Bera Shaylan, Khan Zaid, Vasireddy Satvik, Chalichama Jaladhija, Fidahussain Akbar, Paracha Maria, Ahmed Ziyad, Alyasiry Noor, Engelhardt McKimmon, Kadariya Bishal, Odeh Ahmad, Pitchiah Minu, Rao Nikith, Rueve Joseph, Cepele Iva, Meyer Dixie
Saint Louis University, St. Louis, Missouri.
Saint Louis University, St. Louis, Missouri. ORCID: https://orcid.org/0000-0002-2309-6805.
J Opioid Manag. 2023 Jul-Aug;19(4):343-364. doi: 10.5055/jom.2023.0791.
To review the current literature surrounding the relationship between adverse childhood experiences (ACEs) and opioid use disorder (OUD) to guide clinical identification of high-risk individuals and assess treatment implications.
A PubMed search was conducted from the year 2000 to 2022 using a series of primary and secondary search terms. A total of 21,524 unique results were screened for relevancy to ACEs and OUDs. After excluding unrelated articles, a total of 48 articles were included in this systematic review.
Increased frequency of ACEs was directly related to increased risk of OUD and lower onset age. ACEs were also associated with OUD severity. ACEs linked to OUD included childhood neglect, emotional abuse, physical abuse, and sexual abuse. Additionally, dysfunctional childhood home environment, female gender, and psychiatric/behavioral comorbidities increased the risk of OUD, while resilience was found to be a protective factor. Multiple biochemical markers were associated with both ACEs and OUD.
Children experiencing multiple ACEs should be the target of preventative intervention by medical professionals. Clinicians should include ACEs in their opioid misuse risk assessment. High incidence of co-occurring psychiatric/behavioral disorders provides multiple treatment avenues for patients with OUD. Resilience, along with being therapy target, should be fostered early in the life course. Incorporation of family members may improve opioid abuse treatment outcomes. Future research should focus on interventions interrupting the progression of ACEs to OUD along with proposed biochemical pathways.
回顾当前关于童年不良经历（ACEs）与阿片类物质使用障碍（OUD）之间关系的文献，以指导对高危个体的临床识别并评估治疗意义。
使用一系列主要和次要检索词在2000年至2022年期间进行PubMed检索。共筛选出21524条独特结果，以确定其与ACEs和OUDs的相关性。在排除不相关文章后，本系统评价共纳入48篇文章。
ACEs发生频率增加与OUD风险增加及发病年龄降低直接相关。ACEs还与OUD严重程度相关。与OUD相关的ACEs包括童年期忽视、情感虐待、身体虐待和性虐待。此外，童年家庭环境功能失调、女性性别以及精神/行为共病会增加OUD风险，而复原力被发现是一个保护因素。多种生化标志物与ACEs和OUD均相关。
经历多种ACEs的儿童应成为医学专业人员预防性干预的目标。临床医生应在阿片类物质滥用风险评估中纳入ACEs。共病精神/行为障碍的高发生率为OUD患者提供了多种治疗途径。复原力作为治疗靶点，应在生命早期予以培养。纳入家庭成员可能会改善阿片类物质滥用的治疗效果。未来研究应聚焦于阻断ACEs发展为OUD的干预措施以及提出的生化途径。
