Exploring the link between ACEs and opioid use: A systematic review


  • Ekamjit Deol, BASc
  • Zohair Siddiqui, BS https://orcid.org/0000-0002-2309-6805
  • Awais Paracha, BA
  • Haris Mujovic, BS
  • Zohaib Abro, BS
  • Steven R. Chang, BS
  • Ali Abid, BA
  • Jefferson H. Tyler, MS
  • Humza Rehman
  • Shaylan Bera
  • Zaid Khan, BA
  • Satvik Vasireddy, BS
  • Jaladhija Chalichama
  • Akbar Fidahussain, BS
  • Maria Paracha
  • Ziyad Ahmed, BS
  • Noor Alyasiry, BS
  • McKimmon Engelhardt, BS
  • Bishal Kadariya, BA
  • Ahmad Odeh, BS
  • Minu Pitchiah, BS
  • Nikith Rao, BS
  • Joseph Rueve, BS
  • Iva Cepele, BA
  • Dixie Meyer, PhD




adverse childhood experience, opioid use disorder, opioid, opiate, child abuse, childhood trauma


Objective: To review the current literature surrounding the relationship between adverse childhood experiences (ACEs) and opioid use disorder (OUD) to guide clinical identification of high-risk individuals and assess treatment implications.

Design: A PubMed search was conducted from the year 2000 to 2022 using a series of primary and secondary search terms. A total of 21,524 unique results were screened for relevancy to ACEs and OUDs. After excluding unrelated articles, a total of 48 articles were included in this systematic review.

Results: Increased frequency of ACEs was directly related to increased risk of OUD and lower onset age. ACEs were also associated with OUD severity. ACEs linked to OUD included childhood neglect, emotional abuse, physical abuse, and sexual abuse. Additionally, dysfunctional childhood home environment, female gender, and psychiatric/behavioral comorbidities increased the risk of OUD, while resilience was found to be a protective factor. Multiple biochemical markers were associated with both ACEs and OUD.

Conclusions: Children experiencing multiple ACEs should be the target of preventative intervention by medical professionals. Clinicians should include ACEs in their opioid misuse risk assessment. High incidence of co-occurring psychiatric/behavioral disorders provides multiple treatment avenues for patients with OUD. Resilience, along with being therapy target, should be fostered early in the life course. Incorporation of family members may improve opioid abuse treatment outcomes. Future research should focus on interventions interrupting the progression of ACEs to OUD along with proposed biochemical pathways.


Author Biographies

Ekamjit Deol, BASc

Saint Louis University, St. Louis, Missouri

Zohair Siddiqui, BS

Saint Louis University, St. Louis, Missouri

Awais Paracha, BA

Saint Louis University, St. Louis, Missouri

Haris Mujovic, BS

University of Health Sciences and Pharmacy in St. Louis, St. Louis, Missouri

Zohaib Abro, BS

Saint Louis University, St. Louis, Missouri

Steven R. Chang, BS

Saint Louis University, St. Louis, Missouri

Ali Abid, BA

Saint Louis University, St. Louis, Missouri

Jefferson H. Tyler, MS

Saint Louis University, St. Louis, Missouri

Humza Rehman

Saint Louis University, St. Louis, Missouri

Shaylan Bera

University of Arizona, Tucson, Arizona

Zaid Khan, BA

Idaho College of Osteopathic Medicine, Meridian, Idaho

Satvik Vasireddy, BS

Touro University Nevada College of Osteopathic Medicine, Henderson, Nevada

Jaladhija Chalichama

Saint Louis University, St. Louis, Missouri

Akbar Fidahussain, BS

Saint Louis University, St. Louis, Missouri

Maria Paracha

University of Virginia, Charlottesville, Virginia

Ziyad Ahmed, BS

Saint Louis University, St. Louis, Missouri

Noor Alyasiry, BS

Saint Louis University, St. Louis, Missouri

McKimmon Engelhardt, BS

Saint Louis University, St. Louis, Missouri

Bishal Kadariya, BA

Edward Via College of Osteopathic Medicine, Blacksburg, Virginia

Ahmad Odeh, BS

Saint Louis University, St. Louis, Missouri

Minu Pitchiah, BS

Loyola Stritch School of Medicine, Maywood, Illinois

Nikith Rao, BS

Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois

Joseph Rueve, BS

Saint Louis University, St. Louis, Missouri

Iva Cepele, BA

Saint Louis University, St. Louis, Missouri

Dixie Meyer, PhD

Associate Professor, Department of Family and Community Medicine, Saint Louis University, St. Louis, Missouri


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How to Cite

Deol, E., Z. Siddiqui, A. Paracha, H. Mujovic, Z. Abro, S. R. Chang, A. Abid, J. H. Tyler, H. Rehman, S. Bera, Z. Khan, S. Vasireddy, J. Chalichama, A. Fidahussain, M. Paracha, Z. Ahmed, N. Alyasiry, M. Engelhardt, B. Kadariya, A. Odeh, M. Pitchiah, N. Rao, J. Rueve, I. Cepele, and D. Meyer. “Exploring the Link Between ACEs and Opioid Use: A Systematic Review”. Journal of Opioid Management, vol. 19, no. 4, Aug. 2023, pp. 343-64, doi:10.5055/jom.2023.0791.



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