Adverse Childhood Experiences and Addiction: Understanding the Connection and the Path Toward Healing
Community Service Board of Middle Georgia
The experiences we have during childhood can influence our health and well-being long after childhood ends. For some individuals, experiences involving abuse, neglect, violence, household instability, substance use, or other forms of adversity can affect how they respond to stress, form relationships, regulate emotions, and cope with difficult circumstances later in life.
These experiences are often referred to as adverse childhood experiences, or ACEs.
Research has established an important connection between ACEs and an increased risk for behavioral health concerns, including substance misuse and substance use disorders. However, having experienced childhood adversity does not mean that addiction is inevitable. Understanding the connection can instead help individuals, families, providers, and communities recognize risk factors, strengthen protective factors, and create opportunities for healing and recovery (Centers for Disease Control and Prevention [CDC], 2026).
What Are Adverse Childhood Experiences?
The CDC (2026) defines ACEs as potentially traumatic experiences occurring during childhood, from birth through age 17. ACEs can include experiences that directly happen to a child as well as circumstances within the home or community that affect a child’s sense of safety, stability, and connection.
Examples may include:
- Experiencing physical, emotional, or sexual abuse
- Experiencing physical or emotional neglect
- Witnessing violence in the home or community
- Living in a household affected by substance use
- Living with a family member experiencing significant mental health challenges
- Experiencing parental separation or household instability
- Having an incarcerated household member
- Experiencing homelessness or unstable housing
- Experiencing food insecurity or other significant hardships
(CDC, 2026)
ACEs are common. Importantly, they can affect people from many different backgrounds and communities.
Why Can Childhood Trauma Affect Health Years Later?
Children’s brains and bodies are developing rapidly. When children experience prolonged or repeated adversity without adequate support, the body’s stress-response systems may remain activated for extended periods.
This prolonged stress can influence brain development and the body’s response to stress. Over time, childhood adversity has been associated with increased risks for chronic physical health conditions, mental health concerns, and behaviors such as smoking and heavy alcohol use (CDC, 2021).
Trauma can also influence the ways people learn to cope with uncomfortable emotions.
Someone who experienced significant adversity during childhood may struggle later with anxiety, depression, anger, fear, difficulty trusting others, emotional regulation, or feelings of disconnection. In some cases, alcohol or other substances may initially become a way of coping with painful emotions or memories.
What begins as an attempt to manage distress can eventually contribute to harmful substance use or the development of a substance use disorder.
Understanding the Connection Between ACEs and Substance Use
The relationship between ACEs and addiction is not simply a matter of making poor choices.
Research suggests that exposure to childhood adversity can affect psychological development and biological stress-response systems while increasing the likelihood of developing unhealthy coping strategies (CDC, 2023).
The CDC has also reported associations between ACEs and opioid-related risks. For example, ACE exposure has been associated with opioid misuse, earlier opioid initiation, injection drug use, and overdose. Research among students has demonstrated a dose-response pattern: as the number of ACEs increased, the likelihood of reporting opioid misuse also increased (CDC, 2026).
This does not mean everyone who experiences ACEs will develop a substance use disorder.
ACEs are risk factors—not predictions of a person’s future.
Many individuals who experience significant childhood adversity do not develop addiction, and many people with substance use disorders have different combinations of biological, psychological, environmental, social, and genetic risk factors.
Understanding ACEs simply gives behavioral health professionals another important piece of the individual’s story.
Looking Beyond “What Is Wrong?” to “What Happened?”
Trauma-informed care encourages providers to understand behavior within the context of a person’s experiences.
Instead of viewing substance use only as a behavior that must stop, trauma-informed treatment can explore the circumstances and experiences that may have contributed to that behavior.
The Substance Abuse and Mental Health Services Administration (SAMHSA, 2026) explains that trauma-informed organizations recognize the widespread impact of trauma, recognize its signs and symptoms, integrate knowledge about trauma throughout their practices, and work to avoid retraumatization.
This approach does not excuse harmful behavior or eliminate personal responsibility. Instead, it provides a more complete understanding of what may be contributing to an individual’s behavioral health needs.
That understanding can create opportunities for more effective treatment.
What Does Trauma-Informed Care Look Like?
Trauma-informed care recognizes that individuals seeking behavioral health or substance use treatment may have experienced trauma that affects how safe they feel, how easily they trust others, and how they respond to treatment.
SAMHSA (2026) emphasizes approaches that promote safety, trust, collaboration, empowerment, and recovery.
In practice, trauma-informed behavioral health care may involve:
- Creating environments where individuals feel physically and emotionally safe
- Recognizing signs and symptoms associated with trauma
- Building trust between individuals and treatment providers
- Allowing individuals to participate actively in treatment decisions
- Helping individuals develop healthier coping and emotional regulation skills
- Recognizing individual strengths and resilience
- Avoiding practices that could unnecessarily retraumatize individuals
- Connecting individuals with mental health, substance use, medical, family, and community supports when needed
Trauma-informed care asks providers to see the whole person—not simply a diagnosis, behavior, or history of substance use.
The Importance of Support for Children and Families
Addiction rarely affects only one person.
When a parent, caregiver, sibling, or other loved one struggles with substance use, children may experience confusion, fear, instability, or changes in family relationships. Household substance use itself is recognized as an adverse childhood experience (CDC, 2026).
This is why family-centered services can be an important component of both treatment and prevention.
Children and teens may benefit from age-appropriate opportunities to understand addiction, express emotions, develop healthy coping strategies, strengthen supportive relationships, and learn an important message: they are not alone.
The CDC (2024) identifies safe, stable, and nurturing relationships and environments as important protective factors for children. Positive friendships, supportive adults, strong family connections, access to basic needs, and supportive community networks can also help protect children and promote resilience.
Breaking Cycles Across Generations
One of the most powerful aspects of understanding ACEs is recognizing the opportunity to interrupt cycles of adversity.
Adults who experienced difficult childhoods can build different environments for themselves and their families. Parents and caregivers can learn new coping and parenting strategies. Individuals living with addiction can enter recovery. Families can rebuild relationships. Children can develop meaningful connections with trusted adults.
Communities also play an important role.
The CDC (2024) emphasizes that preventing ACEs requires collaboration across health care, behavioral health, education, social services, government, families, and communities.
Prevention may include strengthening economic supports for families, connecting children with caring adults, increasing access to behavioral health services, supporting parents and caregivers, addressing food and housing insecurity, and creating safe environments where children can learn and grow.
Healing Is Possible
Experiencing childhood trauma can influence someone’s life, but it does not have to define the rest of that person’s story.
SAMHSA (2026) emphasizes that responses to trauma vary considerably. Support systems, resilience, previous experiences, and access to appropriate services can all influence how someone responds to traumatic experiences.
Recovery from substance use disorders is also possible.
For individuals whose substance use is connected to trauma, recovery may involve more than stopping alcohol or drug use. Healing may also include understanding past experiences, developing healthier ways of managing emotions, strengthening relationships, addressing mental health concerns, establishing stability, and building a meaningful life in recovery.
Progress may take time, and every person’s path will look different.
Building Hope Through Understanding
Understanding the connection between adverse childhood experiences and addiction can help move conversations away from judgment and toward compassion, prevention, treatment, and recovery.
When we understand how trauma can influence behavioral health, we can begin asking better questions. We can identify needs earlier. We can strengthen families. We can create safer environments for children. And we can provide treatment that recognizes the experiences behind the symptoms.
At Community Service Board of Middle Georgia, we believe behavioral health care should recognize the whole person—their experiences, strengths, needs, relationships, and potential for recovery.
A difficult beginning does not determine how a person’s story ends. With appropriate support, trauma-informed care, healthy relationships, and access to behavioral health services, individuals and families can move forward toward healing, resilience, and hope.
To learn more about behavioral health, substance use recovery, and community-based services available through Community Service Board of Middle Georgia, visit csbmg.com.
References
Centers for Disease Control and Prevention. (2021). Adverse childhood experiences (ACEs). U.S. Department of Health and Human Services.
Centers for Disease Control and Prevention. (2023). Psychosocial pathways. U.S. Department of Health and Human Services.
Centers for Disease Control and Prevention. (2024). Preventing adverse childhood experiences. U.S. Department of Health and Human Services.
Centers for Disease Control and Prevention. (2026). About adverse childhood experiences. U.S. Department of Health and Human Services.
Hazelden Betty Ford Foundation. (2026). Adverse childhood experiences and addiction: Why is there a connection? Hazelden Betty Ford Foundation.
Substance Abuse and Mental Health Services Administration. (2026). Trauma and violence: What is trauma and its effects? U.S. Department of Health and Human Services.
Substance Abuse and Mental Health Services Administration. (2026). Trauma-informed approaches and programs. U.S. Department of Health and Human Services.