Let's begin with a perceptive quote from Dr. Gabor Mate, a Canadian physician with deep experience working with men and women who are severely addicted to drugs:
The statistics that reveal the typical childhood of the hard-core drug addict have been reported widely but, it seems, not widely enough to have had the impact they ought to on mainstream medical, social, and legal understandings of drug addiction.
Studies of drug addicts repeatedly find extraordinarily high percentages of childhood trauma of various sorts, including physical, sexual, and emotional abuse. One group of researchers was moved to remark that 'our estimates...are of an order of magnitude rarely seen in epidemiology and public health.' Their research, the renowned Adverse Childhood Experiences (ACE) Study, looked at the incidence of ten separate categories of painful circumstances -- including family violence, parental divorce, drug or alcohol abuse in the family, death of a parent, and physical or sexual abuse -- in thousands of people. The correlation between these figures and substance abuse later in the subjects' lives was then calculated. For each adverse childhood experience, or ACE, the risk for the early initiation of substance abuse increased two to four times. Subjects with five or more ACEs had seven to ten times greater risk for substance abuse than did those with none.
In the Realm of Hungry Ghosts: Close Encounters with Addict
The question, Dr. Mate writes, is never Why the addiction?" but Why the pain?
Author Judith Spencer writes:
Dissociation is the common response of children to repetitive, overwhelming trauma and holds the untenable knowledge out of awareness. The losses and the emotions engendered by the assaults on soul and body cannot, however, be held indefinitely. In the absence of effective restorative experiences, the reactions to trauma will find expression. As the child gets older, he will turn the rage in upon himself or act it out on others, else it all will turn into madness.
We could not agree more with Ms. Spencer. The consequences of ACEs often include incarceration related to drug or alcohol abuse. Often, the incarcerations are repeated, as if the door of the jail is revolving.
Taking seriously the impact of ACEs demands they be measured and, once measured, that appropriate interventions are available to those who score high enough to be at risk for bad outcomes, especially substance abuse.