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What are ACEs and How Can They Predict Addiction?

by Landmark Recovery

May 11, 2020
A survey that is used to measure childhood experiences


The social consequences of childhood trauma include a rise in addiction-related crime, higher addiction rates, and greater prison populations. As a community, we need to learn to heal ourselves and help others to heal from emotionally painful childhood experiences so we can improve the health of society as a whole.


Research from 2016 showed that 24% of Hoosiers have experienced at least 2 adverse childhood experiences in contrast to the US average of 21%. The current opioid crisis in states like Indiana, Kentucky, and Ohio shows there’s a need to address the emotional difficulties that people with substance use disorder experience.


Poor emotional health is known to be the root cause of addiction as addictive substances provide momentary relief from difficult memories and emotions.


Today, we’ll examine the research that explains how traumatic childhood experiences affect a child and we’ll explore how this can progress to poor mental health and addiction.


What Are ACEs?

A woman sitting and thinking about adverse childhood experiences and addiction

ACE stands for Adverse Childhood Experiences that someone experiences before they turn 18 years of age. ACEs can be a strong predictor of future addiction.


There are many experiences that children go through that can be classed as traumatic including:


  • Alcoholic parent
  • Divorce
  • Domestic violence
  • Imprisonment
  • Mental illness of a parent
  • Neglect
  • Physical abuse
  • Sexual abuse
  • Substance use
  • Verbal abuse


Any traumatic experience suffered in childhood can take a severe toll on a person’s mental and physical health in later adulthood. Adults who have suffered ACEs have a higher chance of developing substance abuse and other risky behaviors in later life.


ACE Study

Between 1995 and 1997, the care consortium Kaiser Permanente conducted a study on 17,000 people in Southern California to examine the link between childhood abuse and neglect and health later in life.


In the study, people were asked to answer confidential questionnaires related to their childhood experiences, health status, and behaviors.


ACE Definitions

A dictionary where an individual can look up definitions of adverse childhood experiences

The study separated the types of adverse childhood experiences into three main groups:


  • Abuse
  • Household challenges
  • Neglect



Abuse can be sexual, emotional, or physical. All types of abuse can cause severe mental trauma. Emotional abuse is when an adult or family member talks to you in a way that puts you down or makes you feel physically threatened.


Sexual abuse is when anyone over the age of 5 touches you sexually or has sexual intercourse with you when you are a child.


Physical abuse refers to hitting, slapping, or grabbing to the point where it causes harm or physical damage.


Household Challenges

Another form of adverse childhood experience is when a child suffers certain home circumstances which prevent them from enjoying a happy, healthy childhood. Such circumstances can include domestic violence between parents, substance abuse, mental illness, parental divorce, or a family member going to prison.



Children can be traumatized by emotional and physical neglect. If a child is ignored and not supported emotionally, this is classed as emotional neglect. Physical neglect is when a child is not fed and clothed adequately and their medical or dental needs are ignored.


How Are ACEs Measured?

A survey that is used to measure childhood experiences

The Centers for Disease Control and Prevention and Kaiser Permanente devised the ACE score to grade the extent of adverse emotional trauma a person has suffered.


The results from the questionnaire study counted how many ACEs each person suffered starting with zero for no ACEs and maxing out at 4 or more.


ACE Study Results

The study found that 36.1% of participants had suffered no ACEs. Sadly, the rest of the participants found that they had suffered at least one traumatic experience during childhood.


  • 26% experienced 1 ACE
  • 9% experienced 2 ACEs
  • 5% experienced 3 ACEs
  • 5% experienced 4 or more ACEs


How Do ACEs Predict Addiction?

A woman working at her desk wondering if she is a high functioning alcoholic

In psychiatry, addiction is also termed “ritualized compulsive comfort-seeking.” This is considered a natural response to the painful emotions and memories that haunt an adult who has suffered ACEs in childhood.


Various studies indicate that ACEs are an absolute indicator of addiction in later life. A study in Kenya found that 83% of the participants with alcohol use disorder had experienced ACEs.


Other research has found that ACEs suffered during childhood lead to complex mental health disorders, often in dual diagnoses including:


  • Borderline personality disorder
  • Depression
  • Diabetes
  • Obesity
  • Post-traumatic stress disorder


Studies have found that 64% of people with a substance use disorder have suffered at least one ACE. This has huge implications for society at large and it must be addressed using a common-sense approach.

Medication Assisted Treatment

Medication-assisted therapy is considered the gold standard in addiction treatment. Combining prescription medication with group and individual cognitive behavior therapy, it’s possible to learn to better manage the difficult thoughts and emotions that trigger addictive behavior.


Medication-assisted therapy often includes teaching mindfulness techniques like meditation and mind-body practices designed to relax the mind and promote a greater sense of well-being.


Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is an evidence-based treatment used to treat psychological problems ranging from depression, anxiety, and bipolar disorder to PTSD and borderline personality.


CBT works by getting a patient to examine their past history and important life events as well as reactions to certain testing situations. The information they learn about themselves and their thought patterns is then used to devise new coping strategies.


Group behavioral therapy is particularly effective in treating addiction as many find a great sense of support from peers who are experiencing similar difficulties.


New Hope For Those Suffering From Addiction

Anyone who suffers from an addiction can benefit greatly if they seek help to examine their childhood traumas. These are often the most likely the root cause of their substance use disorder.


It is perfectly possible to recover, though. Keep this firmly in mind. Many just like you have successfully recovered and many more are continuing to do so. This is not the end of the road but the chance of a new and improved direction. Understanding why your childhood experiences can trigger negative trains of thought can be the main key to understanding why you turn to substances.


What To Do Next

Right now, we need to do our best to heal our inner child so we can help others to do the same. Maybe this is the way we can move our community forward from the devastating effects of addiction?


It’s possible to recover from addiction and lead a normal healthy and productive life, so never lose hope.


If you need any further assistance, call us today at 888-448-0302. One of our friendly team of experts can help kick start your recovery so feel free to get in touch.


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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.