Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort

Zhang, Yuning, Fernandes, Gwen Sascha, Spiers, Alex, Vaidya, Nilakshi, Sharma, Eesha, Holla, Bharath, Heron, Jon, Hickman, Matthew, Murthy, Pratima, Chakrabarti, Amit, Basu, Debasish, Subodh, B. N., Singh, Rajkumar Lenin, Kalyanram, Kartik, Kartik, Kamakshi, Kumaran, K., Krishnaveni, G.V., Kuriyan, Rebecca, Kurpad, Sunita Simon, Barker, Gareth, Bharath, Rose Dawn, Desrivieres, Sylvane, Purushottam, Meera, Orfanos, Dimitri Papadopoulos, Toledano, Mireille B., Schumann, Gunter and Benegal, Vivek (2021) Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort. BMC Public Health, 21, 1-13, [1920 (2021)]. (doi:10.1186/s12889-021-11892-5).

Abstract

Background
Adverse childhood experiences (ACEs) increases vulnerability to externalising disorders such as substance misuse. The study aims to determine the prevalence of ACEs and its association with substance misuse.

Methods
Data from the Consortium on Vulnerability to Externalising Disorders and Addictions (cVEDA) in India was used (n = 9010). ACEs were evaluated using the World Health Organisation (WHO) Adverse Childhood Experiences International Questionnaire whilst substance misuse was assessed using the WHO Alcohol, Smoking and Substance Involvement Screening Test. A random-effects, two-stage individual patient data meta-analysis explained the associations between ACEs and substance misuse with adjustments for confounders such as sex and family structure.

Results
1 in 2 participants reported child maltreatment ACEs and family level ACEs. Except for sexual abuse, males report more of every individual childhood adversity and are more likely to report misusing substances compared with females (87.3% vs. 12.7%). In adolescents, family level ACEs (adj OR 4.2, 95% CI 1.5–11.7) and collective level ACEs (adj OR 6.6, 95% CI 1.4–31.1) show associations with substance misuse whilst in young adults, child level ACEs such as maltreatment show similar strong associations (adj OR 2.0, 95% CI 1.1–3.5).

Conclusion
ACEs such as abuse and domestic violence are strongly associated with substance misuse, most commonly tobacco, in adolescent and young adult males in India. The results suggest enhancing current ACE resilience programmes and ‘trauma-informed’ approaches to tackling longer-term impact of ACEs in India.

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Contributors

Author: Yuning Zhang

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