Associations between Adverse Childhood Experiences and Performance-Enhancing Substance Use among Young Adults

ABSTRACT

Background and Objective

Adverse childhood experiences (ACEs) are associated with negative health outcomes, yet their associations with performance-enhancing substance (PES) use are unclear. This study aimed to determine whether ACEs predict greater use of legal and illegal PES in young adults.

Methods

We analyzed data from the National Longitudinal Study of Adolescent to Adult Health (n = 14,322), Waves I (1994–1995) and III (2001–2002). ACEs included childhood sexual abuse, physical abuse, two neglect indicators, and cumulative ACEs. Legal (e.g. creatine monohydrate) and illegal (e.g. non-prescription anabolic-androgenic steroids; AAS) PES use was assessed.

Results

Sexual abuse had the greatest effect and predicted higher odds of legal PES use (men: adjusted odds ratio [AOR] 1.66, 95% confidence interval [CI] 1.06-2.59; women: AOR 3.74, 95% CI 1.63-8.59) and AAS use (men: AOR 8.89, 95% CI 5.37-14.72; women: AOR 5.73, 95% CI 2.31-14.18). Among men, a history of physical abuse (AOR 3.04, 95% CI 2.05-4.52), being left alone by a parent/guardian (AOR 2.33, 95% CI 1.50-3.60), and basic needs not being met (AOR 3.47, 95% CI 2.30-5.23) predicted higher odds of AAS use. Among women, basic needs not being met (AOR 2.94, 95% CI 1.43-6.04) predicted higher odds of AAS use. Among both men and women, greater number of cumulative ACEs predicted higher odds of both legal and illegal PES use.

Conclusions

ACEs predict greater PES use among young adults. Clinicians should monitor for PES use among those who have experienced ACEs and provide psychoeducation on the adverse effects associated with PES use.

KEYWORDS:

• Adverse childhood experiences
• sexual abuse
• creatine monohydrate
• anabolic steroids
• young adults

Acknowledgements

We would like to thank Sam Benabou for providing editorial assistance. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Information on how to obtain the Add Health data files is available on the Add Health website (https://addhealth.cpc.unc.edu). No direct support was received from grant P01-HD31921 for this analysis.

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Financial disclosure

The authors report no financial disclosures.

Additional information

Funding