Family History of Alcohol and Drug Abuse, Childhood Trauma, and Age of First Drug Injection

Abstract

Background: Childhood maltreatment may lead to development of future substance use; however the contributions of a family history of substance use is unclear. Objectives: To better understand the relationship between childhood abuse, family history of alcohol and drug abuse, and injecting drug use initiation in a cohort of chronic opioid users. Methods: A cross-sectional survey of long-term and difficult to treat intravenous opiate users of the North American Opiate Medication Initiative (NAOMI) cohort was conducted in two Canadian cities (Vancouver and Montreal). For the analysis, we selected a subsample (n = 87) of the population reported experiencing childhood abuse and completed a 12-month follow up. The sample was 41.4% female and 14.9% First Nations, with a mean age of 38 years. This sample then completed the Childhood Trauma Questionnaire (CTQ) and the Addiction Severity Index (ASI) beside others. Results: Maternal alcohol and drug use was significantly associated with childhood sexual abuse, emotional abuse, and physical neglect. Paternal alcohol and drug use was significantly associated with childhood physical abuse. Increased severity of all types of childhood trauma was related to an earlier age of first injection. Conclusions/Importance: Family history of drug and alcohol use is strongly associated with childhood trauma, which may, in turn, lead to an earlier initiation to the dangerous routes of drug injection.

Keywords :

• child abuse
• substance use disorders
• intravenous drug abuse
• family health

THE AUTHORS

Chris Taplin is entering into his 4th year of medical school at UBC with an interest in rural family medicine. He looks forward to continually engaging with the complex interplay between mental health and addictions as a physician in the near future.

Dr. Sahoo Saddichha is currently employed as Senior Psychiatry Registrar with Melbourne Health, Victoria, Australia. He has a Clinical Fellowship in Dual Diagnosis & Addiction Psychiatry from the University of British Columbia, Canada. He has more than 90 publications to his credit and is on the Editorial Board of three journals and serves on the review board of several others.

Kathy Li was until recently working with the Institute of Mental Health, UBC as Senior Statistician. She has now moved on to work with the Brain Research Centre, UBC as Senior Statistician.

Dr. Michael Krausz holds an LEEEF chair in addictions medicine at the University of British Columbia. Dr. Krausz is a founding fellow of the Institute of Mental Health at UBC, a research leader in the Centre for Health Evaluation and Outcome sciences (CHEOS), and an active member of the Department of Psychiatry and its Executive. Dr. Krausz has served on the Scientific Advisory Board of the Michael Smith Foundation and on the SAC for the Canadian Center of Substance Abuse (CCSA) and the Steering committee for EMH at the Mental Health Commission of Canada (MHCC).

GLOSSARY

• Childhood trauma: It generally refers to the traumatic experiences that occur to children which can be the result of intentional violence—such as child physical or sexual abuse, or domestic violence—or the result of natural disaster, accidents, or war. Young children also may experience traumatic stress in response to painful medical procedures or the sudden loss of a parent/caregiver.

• Child neglect: This occurs when a parent or caregiver does not give a child the care he or she needs according to its age, even though that adult can afford to give that care or is offered help to give that care. Neglect can mean not giving food, clothing, and shelter.

• Child sexual abuse: This includes a wide range of sexual behaviors that take place between a child and an older person or alternatively between a child and another child/adolescent.

• Emotional abuse: Emotional abuse of a child is commonly defined as a pattern of behavior by parents or caregivers that can seriously interfere with a child's cognitive, emotional, psychological, or social development. This may be in the form of isolating, rejecting, neglecting, terrorizing, or exploiting a child.

• Physical abuse: This means causing or attempting to cause physical pain or injury. It can result from punching, beating, kicking, burning, or harming a child in other ways.