09 Sep Is Child Abuse Linked to Relapses in Adults with Substance Use Disorder?
Researchers and public health officials know that people with a history of child abuse or child neglect have increased chances of developing diagnosable problems with substance abuse or substance addiction (i.e., substance use disorder) in adulthood. After entering recovery, significant numbers of individuals diagnosed with this disorder will relapse temporarily or permanently back into substance use. In a study published in June 2014 in the American Medical Association journal JAMA Psychiatry, researchers from two U.S. universities looked at the changes in brain function that heighten the risks for relapse and assessed whether individuals with a history of child abuse or neglect have increased chances of relapsing during substance abuse or addiction treatment.
Child Abuse and Neglect
Child abuse and child neglect are unfortunately fairly common occurrences in the U.S. and throughout the world. In America, a nationwide law called the Federal Child Abuse Prevention and Treatment Act sets the basic terms for defining both forms of childhood mistreatment. In turn, each state uses this federal statute as the source for its own criminal code. Child abuse comes in three main forms: physical abuse that involves intentional and excessive violence; sexual abuse that involves a child in a sexual act, exposes a child to sexual acts or subjects a child to sexual exploitation; and emotional abuse that relies on verbal or physical acts to seriously interfere with a child’s psychological well-being. Child neglect centers on a shirking of the responsibilities a parent or guardian has toward a child, and can include things such as lack of financial or material support, education, medical care or a failure to provide a reasonably safe home environment.
Substance Use Disorder
Substance use disorder is the current diagnosis that doctors make for people who are addicted to a drug, medication or alcohol, as well as for people who establish a serious pattern of drug, medication or alcohol abuse in the absence of physical addiction. This combined diagnosis, established in May 2013 by the American Psychiatric Association, is based on a solid scientific consensus that shows that issues of addiction and abuse often appear together in the same person, in addition to appearing on their own. Besides alcohol, substances specifically identified by the APA as potential sources of substance use disorder include stimulant drugs/medications (e.g., amphetamine and cocaine), opioid drugs/medications (e.g., heroin and oxycodone), tobacco/nicotine, hallucinogens and sedative or tranquilizing medications.
Increased Relapse Risks?
In the study published in JAMA Psychiatry, researchers from the New York University School of Medicine and the Yale University School of Medicine used magnetic resonance imaging (MRI) scans to examine the brains of 79 people in treatment for substance use disorder. Some of these individuals had a history of childhood abuse and/or neglect, while others did not. The study also included 98 people unaffected by substance use disorder, some of which also had histories of childhood abuse and/or neglect. In each group of participants, the researchers specifically looked for certain changes in the brain that have previously been linked to increased risks for relapsing after establishing a pattern of substance abstinence.
After analyzing the results of the MRI exams, the researchers concluded that study participants with a history of childhood abuse or neglect showed clear indications of relapse-related changes in their normal brain function. Among the participants in treatment for substance use disorder, these changes were in fact linked to a heightened chance of experiencing a relapse. The researchers concluded that this increased relapse risk is roughly the same for all substances under consideration. They also concluded that brain changes found in people with a history of childhood abuse or neglect commonly lead to particularly severe relapse episodes.
The study’s authors note that roughly four or five out of every 10 people who experience neglect or abuse during childhood will eventually develop diagnosable substance problems later in life. They also note the prominent role of childhood abuse and neglect in the onset of mental illness. The authors believe their findings indicate that a history of child abuse or neglect can potentially substantially alter the requirements for the effective treatment of substance use disorder. They also believe that programs designed to address the effects of substance use disorder may improve their outcomes considerably by taking such a history into account when working with their patients/clients.
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