VCOM Research Day Program Book 2023

Medical Student Research Publ ic Health

08 The Association Between Adverse Childhood Experiences (ACEs) and Substance Use in 2019-2020in Virginia: An Analysis of Heavy Alcohol Use and Injectable Drug Use

Prerna M. Yadav, OMS II; Lorissa C. Simpson, OMS II; Theresa J. McCann, PhD, MPH Corresponding author: pyadav@vt.vcom.edu

Edward Via College of Osteopathic Medicine, Virginia Campus

Substance Use Disorder (SUD) is a condition that impacts millions of Americans and their families. Despite advances in awareness and treatment for SUD, it remains a growing problem in the United States, exacerbated in recent years by the SARS COV2 pandemic. Since 2019, there has been a 29% increase in overdose deaths in the US, 75% of these deaths involved synthetic opioids. Within the New River Health District, the rate of substance-related deaths per 100,000 in the District are as follows: Pulaski County 24.44, Montgomery County 9.79, Floyd County 8.46, Giles County 13.89, and the town of Radford 17.73. These data demonstrate considerable variation in deaths from SUD within the New River Health District, despite similar locations and access to resources. This represents a strong need to look deeper into factors that may be associated with SUD. The association between adverse childhood experiences (ACEs) and substance use disorders is well documented. ACEs are defined as any potentially traumatic event that can have negative long-term

effects on health and well-being. These factors include exposure to psychological, physical, or sexual abuse and household dysfunction. Several studies have documented associations between increased ACE scores and poor behavioral and physical health outcomes later in life. This project addresses two specific categories of substances: heavy alcohol use and injectable drug use. The objective is to review data from the Behavioral Risk Factor Surveillance System (BRFSS), a randomized national telephone survey conducted by the Center for Disease Control and Prevention (CDC) that collects information about health-related risk behaviors. We assessed data from 2019 and 2020 for associations between ACEs, heavy alcohol use and injectable drug use in Virginia, including the New River Health District. The hypothesis is that the presence of an ACE score of 4 or more is associated with a higher potential for heavy alcohol use and

injectable drug use. Descriptive statistics with sums and proportions were performed using the SPSS Statistical Software. Further analyses were performed with Crosstabs and Pearson Chi-square tests, with a statistical significance at p<0.05. ACE scores were split based on two categories: scores between 0-3 and scores between 4-11. The preliminary analyses showed an association between higher ACE scores and injectable drug use with a p-value of p<0.001 and heavy alcohol use with a p-value of p=0.003. This is an ongoing project to evaluate additional substances and social determinants of health (SDH) to better understand the relationship with substance use in Virginia. Moreover, the effect of the SARS-COV2 pandemic can also be addressed.

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