CHILD & ADOLESCENT HEALTH
AN INNOVATIVE TOOL TO PREVENT CHILDHOOD ADVERSITY AND IMPROVE EMOTIONAL, PHYSICAL, AND SOCIAL OUTCOMES Charlene Renaud
Over a 25-year career in lawenforcement, I witnessed the escalation and severity of mental illness and addiction, a tragic pandemic in communities across the U.S., Canada, and the world.
One of the significant catalysts contributing to the current state was the introduction of oxycodone (OxyContin) by Pur-due Pharma in the mid-1990s. I remember the progression of its use and abuse on the streets and decided to introduce pro-active drug education projects in my community. A tidal wave of social destruction was mounting beneath the surface. Addiction was grow-ing exponentially with too little done, too late. Despite the addictive nature of oxy (street slang), it continued to be over-prescribed and heavily marketed, leaving thousands of lives in turmoil. Following, unfolded the abuse of the noncrushable version of oxycodone, methamphetamine, fentanyl, and anything a person could make or take to get high.
As overdoses escalated, every officer carried naloxone as a standard to counter opioid overdose effects. Stories of people being revived from death were common. I worked in the court unit and made frequent trips to the hospital with prisoners experiencing severe withdrawals, an overdose, or an attempted or threatened suicide. Many shared a common thread of adverse childhood experiences: abuse (physical, emotional or sexual), trauma, abandonment, someone in the home, which was a drug abuser or violent toward others in the home, and other unhealthy exposures.
In the Morbidity and Mortality Weekly Report. 2019; Vol. 68 No. 44: p. 999-1005 by Melissa T. Merrick, Ph.D. et al., titled “Estimated Proportion of Adult Health Problems Attributable to Adverse Childhood Experi-ences and Implications for Pre-vention — 25 States, 2015-2017,” the association between life outcome and adverse childhood experiences (ACEs) were assessed.
The U.S. study used BRFSS (Behavioral Risk Factor Surveillance System) with 144,017 respondents from 25 U.S. states, reporting on a range of health conditions and risk behaviors. The respondents reported adverse childhood experiences, ranging from none to four or more, i.e., exposure to abuse: mental, physical, emotional; household challenges, such as a household member with substance misuse, incarcerated, mentally ill; parental divorce; or witnessing intimate partner violence before the age of 18. The study group also report-ed if they had any of these conditions (as advised by their healthcare professional): coronary heart disease, stroke, asthma, chronic obstructive pulmonary disease (COPD), cancer (excluding skin), kidney disease, diabetes, and depression.
Other topics in the survey included reporting BMI (Body Mass Index) to determine participants’ overweight or obesity statuses, smoking history and current use, and heavy drinking of alcoholic beverages. The respondents also record-ed socioeconomic challenges, including lack of health insurance, unemployment status, and level of education. The above researchers concluded:
“Adverse childhood experi-ences, such as violence, victim-ization, substance misuse in the household, or witnessing intimate partner violence, have been linked to leading causes of adult morbidity and mortal-ity. Therefore, reducing adverse childhood experiences is critical to avoiding multiple negative health and socioeconomic out-comes in adulthood. … “Nearly one in six adults of the study population reported four or more adverse childhood experiences. Adverse childhood experiences were significantly associated with poorer health outcomes, health risk behaviors, and socioeconomic challenges.
“Efforts that prevent adverse childhood experiences could also potentially prevent adult chronic conditions, depression, health risk behaviors, and negative socioeconomic outcomes. States can use comprehensive public health approaches derived from the best available evidence to prevent childhood adversity before it begins. By creating the conditions for healthy communities and focusing on primary prevention, it is possible to reduce the risk of adverse childhood experiences while also mitigating consequences for those already affected by these experiences.
“… adverse childhood experiences can derail optimal health and development by altering gene expression, brain connectivity and function, immune system function, and organ function. (8) Adverse childhood experiences can also compromise the development of healthy coping strategies, which can affect health behaviors, physical and mental health, life opportunities, and premature death. … Adverse childhood experiences have been linked to increased risk for alcohol and substance use disorders, suicide, mental health conditions, heart disease, other chronic illnesses, and health risk behaviors throughout life. …
“At least five of the ten leading causes of death have been associated with exposure to adverse childhood experiences, including several contributors to declines in life expectancy. … “Preventing adverse childhood experiences is critical to ad-dressing multiple public health and social challenges and to improving the lives of children, families, and communities.”
“At least five of the ten leading causes of death have been associated with exposure to adverse childhood experiences, including several contributors to declines in life expectancy. … “Preventing adverse childhood experiences is critical to ad-dressing multiple public health and social challenges and to improving the lives of children, families, and communities.”