Bad news-good news: Each additional ACE increases opioid relapse rate by 17%; each ACE-informed treatment visit reduces it by 2%

Aopioids2Photo by Ian Sheddan via Flickr Creative Commons
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It’s no surprise that serious childhood trauma can lead people to use opioids. In the absence of healthy alternatives and an understanding of how experiences — such as living with a parent who’s alcoholic or depressed, divorce, and being constantly yelled at when you’re a kid — can make your adult life miserable, opioids help many people cope with chronic depression, extreme anxiety and hopelessness.

But a new study has shown the significance of ACEs and ACEs-science-informed treatment: Each additional type of adverse childhood experience increases a person’s risk of relapse during medication-assisted opioid treatment by a whopping 17 percent. And each visit to a clinic that integrates trauma-informed practices based on ACEs science reduced the relapse rate by two percent, which can carry a person perhaps not to zero, but to a minimal risk of relapse.

“This research clearly shows the lasting impact that ACEs (adverse childhood experiences) can have,” says Dr. Karen Derefinko, lead author and assistant professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center, and director of the National Center for Research of the Addiction Medicine Foundation. “I think it’s the first research to connect ACEs to relapse.”

Researchers from the University of Tennessee Health Science Center and the University of Memphis also found that more than half (54%) of people in a rural Tennessee opioid clinic relapsed, and the highest relapse rate was on the first visit. Almost half of the 87 people who participated in the study had an ACE score of four or higher — the average was 3.5, which is remarkably high. The study, “Adverse childhood experiences predict opioid relapse during treatment among rural adults”, appears in the September 2019 issue of the journal, Addictive Behaviors, and was published online last week.

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Dr. Karen Derefinko

“This study will help practitioners understand the importance of providing trauma-informed treatment,” says Derefinko. “Because of the stigma associated with drug use, it’s hindered health care workers’ understanding of why people use drugs and has led to an assumption that they’re bad people. This shows that trauma-informed care and providing resources does impact how well people can do. It’s also validating for patients and gives them a lot of hope.”

 

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The most important thing I didn’t learn about in medical school: Adverse childhood experiences

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Dr. Nancy Hardt

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The most important thing I didn’t learn in medical school is about adverse childhood experiences, also known as ACEs.

To be sure, if I had understood them then the way I do now, I would have been a better and more compassionate physician. Importantly, I would have avoided lots of mistakes.

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Just one year of child abuse costs San Francisco, CA, $300 million….but it doesn’t have to

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In 2015, 5,545 children in San Francisco, CA, were reported to have experienced abuse. Of those, the reports of 753 children were substantiated. The expense to San Francisco for not preventing that abuse will cost $400,533 per child over his or her lifetime. That adds up to $301.6 million for just that one year, according to “The Economics of Child Abuse: A Study of San Francisco.”

And, because child abuse is profoundly underreported, the costs are likely to be as much as $5.6 billion for one year of children experiencing trauma, the report found.

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Pueblo, CO, clinic rewrites the book on primary medical care by asking patients about their childhood adversity

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In October 2015 in Pueblo, CO, the staff members of a primary care medical clinic – Southern Colorado Family Medicine at the St. Mary-Corwin Medical Center – start asking parents of newborn babies to kids five years old about the parents’ adverse childhood experiences and the resilience factors in their lives. They ask the same questions of pregnant women and their partners in the hospital’s high-risk obstetrics clinic.

The results are so positive after the first year that the clinic starts asking parents of kids up to 18 years old. The plans are to do the same in the hospital’s emergency room.

Why? They think it gives kids a leg up on a healthier start in life. They think it helps adults understand and manage their own health better. They think it helps physicians better understand and help their patients. Oh yeah – and it looks like it’s going to save money. Probably a lot of money.

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Congressional briefing addresses public policy to improve response to ACEs

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In the final weeks of the 114th Congress, Senator Heidi Heitkamp (D-ND) welcomed her colleague Senator Dick Durbin (D-IL) as a new host for the third and final briefing on addressing adverse childhood experiences (ACEs). The December 1 briefing focused on public policies to improve coordination, prevention and response to childhood trauma.

ACEs comes from the CDC-Kaiser Permanente Adverse Childhood Experiences Study and subsequent surveys that show that most people in the U.S. have at least one ACE, and that people with an accumulation of childhood adversities — including divorce, racism, living with an alcoholic parent, and physical abuse — have a higher risk of adult onset of chronic health problems such as heart disease, cancer, diabetes, suicide, and alcoholism.

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I’m not cured, but I am healing

Donna Jackson Nakazawa

Donna Jackson Nakazawa

More than 133 million American adults — one in two of us — suffer from a chronic condition, including autoimmune disease, fibromyalgia, digestive disorders, migraines, back pain, depression, diabetes, cancer and chronic pain. A recent study published in JAMA Internal Medicine found that those of us in our 40s, 50s and 60s are twice as likely as our parents were to suffer from debilitating chronic conditions in middle age.

I’m one of those statistics. I’ve spent much of the past decade navigating my life around health crises. Twice I’ve been paralyzed by Guillain-Barre Syndrome, an autoimmune disease similar to multiple sclerosis, but with a more sudden onset and a wider array of possible outcomes. Other diagnoses — low blood cell counts, thyroiditis and the need for a pacemaker — have also complicated my health and my life.

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8 ways people recover from post childhood adversity syndrome

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Cutting-edge research tells us that experiencing childhood emotional trauma can play a large role in whether we develop physical disease in adulthood. In Part 1 of this series we looked at the growing scientific link between childhood adversity and adult physical disease. This research tells us that what doesn’t kill you doesn’t necessarily make you stronger; far more often, the opposite is true.

Adverse Childhood Experiences (ACEs)—which include emotional or physical neglect; verbal humiliation; growing up with a family member who is addicted to alcohol or some other other substance, or who is depressed or has other mental illness; and parental abandonment, divorce, or loss — can harm developing brains, predisposing them to autoimmune disease, heart disease, cancer, depression, and a number of other chronic conditions, decades after the trauma took place.

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7 ways childhood adversity changes a child’s brain

 

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If you’ve ever wondered why you’ve been struggling a little too hard for a little too long with chronic emotional and physical health conditions that just won’t abate, or feeling as if you’ve been swimming against some invisible current that never ceases, a new field of scientific research may offer hope, answers, and healing insights.

The single best medical appointment of my life was when a nurse practitioner asked about my adverse childhood experiences (ACEs)

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Heidi Aylward spent much of 2015 going to doctor’s appointments for back and joint pain, dizziness, swelling of the legs and feet, high blood pressure, elevated platelets, heart palpitations and extreme fatigue.

2016 isn’t looking much better. She’s worn a heart monitor, had a bone marrow biopsy and continues to have blood work. She holds down a job as a full-time project manager, tends to her daughters, home and pets.

But she feels like her body is falling apart.

“I’m not going to make it to 60,” she said, “Why do I even contribute to my retirement savings account?”

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Johnna Janis makes documentary “Invisible Scars” to heal her and others’ childhood trauma

Invisible Scars“It’s about so much more than childhood sexual abuse,” says Johnna Janis about her feature documentary, Invisible Scars, a remarkable film about her own sexual abuse and her journey of recovery.

Janis produced and directed the film with long-time friend, Sergio Myers, an award-winning filmmaker and owner of 7Ponies Productions. Together, they took on topics many would consider too triggering or taboo to address and did so without sensationalizing sexual abuse or trivializing trauma. The result is a personal, powerful and informative movie.

Invisible Scars, which has been a six-year labor of love, will have a red-carpet premiere March 29 at the Harmony Gold Theater in Los Angeles, CA. It received an Award of Merit at IndieFest 2015.

What started in 2010 as a “small little project” about one woman’s healing journey “expanded” when Janis learned about the CDC-Kaiser Permanente Adverse Childhood Experiences Study (ACE Study).

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