Adverse Childhood Experiences (ACEs)—such as abuse, neglect, and household dysfunction—have long been known to shape a child’s emotional and psychological development. But growing evidence shows that ACEs are also one of the strongest predictors of alcohol and substance use later in life. Multiple studies, including systematic reviews and population studies, consistently demonstrate a clear and measurable link between childhood trauma and later addiction.
Understanding this connection helps families, communities, and policymakers support prevention, early intervention, and healing.
How ACEs Shape Behaviour and Coping Mechanisms
Children exposed to trauma often live in a constant state of fear, confusion, or insecurity. To cope with overwhelming emotions, many develop survival-based behaviours:
- suppressing feelings
- dissociating
- shutting down emotionally
- seeking anything that brings temporary relief
For some, alcohol or drugs become a form of self-medication, temporarily numbing emotional pain, reducing anxiety, or providing an escape from traumatic memories.
A major systematic review of ACEs and substance use by Sebalo et al. (2023) found “clear evidence that exposure to multiple ACEs is a robust risk factor” for using alcohol, cannabis, and other drugs in young adulthood. Researchers emphasised that trauma often leads to poor self-regulation and maladaptive coping, which is a key pathway into early substance use.
The Science Behind Trauma and Addiction Risk
1. Brain Development
Trauma during childhood changes how the brain grows, especially in areas responsible for emotions, impulse control, and decision-making. These changes increase the likelihood of turning to substances for relief.
2. Stress Response System
Chronic stress alters the body’s stress-response system (HPA axis), making a person more vulnerable to addiction. Trauma can make the brain hypersensitive to stress—making alcohol or drugs feel like a quick solution.
3. Learned Behaviour
Children who grow up around violence, conflict, or household substance abuse often begin to see these behaviours as “normal,” which can influence the choices they make later in life. This sense of normalisation increases the likelihood of experimenting with alcohol or drugs at an earlier age. A U.S study conducted by Hughes et al.,( 2018) using national data found that adults who experienced household abuse in childhood were significantly more likely to binge drink (OR = 1.30) or drink regularly (OR = 1.21) compared to those without ACEs.
What Research Shows: ACEs Significantly Increase Risk of Alcohol & Drug Use
The relationship is not a theory—it’s well established across countries and age groups:
A 12–14-year longitudinal study in Norway
A Norwegian 12–14-year longitudinal study of over 8,000 participants found that individuals with any history of ACEs were 4.3 times more likely to develop a substance use disorder in adulthood, with emotional neglect and sexual abuse particularly predictive of alcohol use disorder among women (Broekhof et al., 2023).
ACEs lead to earlier alcohol use
A classic ACE study involving more than 8,000 adults demonstrated a clear dose–response relationship, where a higher number of ACEs was linked to earlier initiation of alcohol use, often beginning at or before age 14 (Anda et al., 2002).
Young Adults with Multiple ACEs Report Higher Alcohol-Related and Drug Dependence Symptoms
A latent class analysis of 336 young adults (aged 18–25) revealed that individuals in the “High/Multiple ACEs” class reported significantly more alcohol-related problems and drug dependence symptoms compared to those in the “Low ACEs” class (Shin, McDonald, & Conley, 2017).
ACEs and substance misuse in India (cVEDA cohort)
A large cohort of 9,010 youth showed that ACEs—especially at family and community level—were strongly associated with alcohol, cannabis, and tobacco misuse (Fernandes et al., 2021).
ACEs affect recovery outcomes too
A study conducted by Borgert et al., 2022 revealed that among adults in treatment for alcohol or drug use disorder, those with higher ACE scores had:
- more PTSD and depression symptoms
- lower self-efficacy for staying sober
- more difficulty maintaining abstinence
This means ACEs don’t just increase the risk of addiction — they also influence how hard recovery can be.
Impact on Families and Communities
The consequences of alcohol and substance abuse ripple outward:
- Families may experience conflict, financial stress, neglect, or domestic violence.
- Children in these homes are more likely to develop ACEs themselves — continuing the cycle.
- Communities may face increased crime, mental health concerns, and health system strain.
Understanding ACEs helps break this cycle at its roots.
Promoting Prevention and Building Resilience
While ACEs increase risk, addiction is not inevitable. Many people with high ACE scores never develop substance problems—thanks to protective factors like:
- supportive relationships
- trauma-informed care
- safe and stable environments
- access to counselling
- school or community programs
- faith-based or mentorship networks
Evidence shows that early intervention, family support, and building emotional regulation skills significantly reduce the likelihood of substance misuse.
Conclusion
Childhood trauma shapes brain development, emotional regulation, and coping patterns that increase the risk of alcohol and substance use. Research from across the world confirms that ACEs are one of the strongest predictors of addiction in adolescence and adulthood.
By understanding this connection, communities can create better prevention programs, families can receive support earlier, and individuals can find healing and resilience.
Suggested Internal Links
✔ Take the ACEs Questionnaire – Understand your risk factors.
✔Understand Your ACEs Score – What It Means for You.
✔ Learn more about ACEs – Explore how trauma affects long-term health.
References:
Sebalo, I., Königová, M. P., Vňuková, M. S., Anders, M., & Ptáček, R. (2023). The Associations of Adverse Childhood Experiences (ACEs) with Substance Use in Young Adults: A systematic review. Substance Abuse Research and Treatment, 17, 11782218231193914. https://doi.org/10.1177/11782218231193914
Hughes, K., Bellis, M. A., Hardcastle, K. A., Sethi, D., Butchart, A., Mikton, C., Jones, L., & Dunne, M. P. (2018). Impact of adverse childhood experiences (ACEs) on adult alcohol consumption behaviors. Substance Abuse Research and Treatment, 12, 11782218231193914. https://doi.org/10.1177/11782218231193914